Complication Of Acute Mastoiditis Research Articles

Complications of acute mastoiditis in a paediatric population at a UK Tertiary Centre: A retrospective review.

Acute mastoiditis (AM) and its associated intra and extracranial complications are rare complications of acute otitis media. However, they are associated with a high morbidity. The management of AM with complications carries significant variations in approach. We aimed to evaluate the presentation of children with AM with complications to a tertiary referral centre in the United Kingdom and describe evolution of the treatment approaches. We undertook a retrospective chart review ofall children admitted with AM to the University Hospitals of Leicester between 2013 and 2022. Twenty-seven children were included in this study: 7 patients had sigmoid sinus thrombosis (SST), 4 had an intracranial collection, 3 had cranial nerve palsy and 16 had a subperiosteal abscess (SPA); some patients had more than 1 complication. In this study, treatment of SPA with incision and drainage (I&D) and grommet insertion was effective, as all patients treated with grommet insertion and I&D recovered well and did not require a subsequent cortical mastoidectomy. All patients with SST received anticoagulation and intravenous (IV) antibiotics; surgical input consisted of grommet insertion alone and cortical mastoidectomy was not routinely performed in these patients. In our series, management of SPA with grommet insertion and drainage had good outcomes. SST management mainly consisted of IV antibiotics, anticoagulation and grommet insertion with good recovery. The evidence to guide the management of complications of mastoiditis is of poor quality and further research is needed to clarify the optimal management of these complications.

Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review

BackgroundCerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011.Case presentationThe child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient’s full recovery.ConclusionCerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.

Paediatric Temporomandibular Joint Septic Arthritis: A Complication of Acute Mastoiditis

Septic Temporomandibular joint (TMJ) arthritis is an unusual complication of acute mastoiditis in children. This is a case of acute mastoiditis in a 7 years old child following an acute otitis media ear infection, which presented with ear discharge, trismus, mastoid area erythema and TMJ swelling and pain. CT scan showed opacification of mastoid temporal bone and TMJ area. Treatment included antibiotics and TMJ abscess surgical drainage. In this case report, we discuss the clinical picture, investigations, treatment and literature review for this case. Multidisciplinary approach (ENT, Paediatrics, and Oral and Maxillofacial surgeons) was mandatory to manage this unusual complication in children.

Outpatient management of pediatric acute mastoiditis

ObjectiveEvaluate the Montreal Children's Hospital experience with outpatient management of uncomplicated acute mastoiditis with parenteral antibiotic therapy alone and determine if it is a safe alternative to inpatient management. Subjects and methodA retrospective review of pediatric patients diagnosed with acute mastoiditis at a tertiary care pediatric hospital between 2013 and 2015 was performed. Patients with syndromes, immunodeficiency, cholesteatoma, chronic otitis media, cochlear implant in the affected ear, or incidental mastoid opacity were excluded. Results56 children age 6 months to 15 years old were treated for acute mastoiditis, including 29 hospitalizations and 27 outpatients. Patients managed as outpatient with daily intravenous ceftriaxone had a 93% cure rate. Eighteen hospitalized and one outpatient had complications of acute mastoiditis. Children with complications were more likely to be febrile (p = 0.045). Two patients failed outpatient therapy and were admitted; one for myringotomy and piperacillin-tazobactam treatment and one required a mastoidectomy. 4/27 children treated as outpatient underwent myringotomy and tube insertion, 2 underwent myringotomy and tube along with admission and 21 did not require tube insertion. The average total duration of intravenous antibiotic therapy was respectively 4.9 and 18.9 days in the outpatient and hospitalized group. The average duration of admission was 5.9 days. ConclusionOutpatient medical therapy of uncomplicated pediatric mastoiditis is safe, successful, and efficient. Benefits include efficient use of surgical beds, cost savings and patient and family convenience. Careful patient selection and close monitoring are keys for successful outcome.

Complications of Acute Mastoiditis in a Child in this Era of Antibiotics

Complications of Acute Mastoiditis in a Child in this Era of Antibiotics

Spontaneous drainage of a Bezold neck abscess into the middle-ear cleft: a rare incident

Bezold’s abscess is a neck abscess, arising as a complication of acute mastoiditis or active chronic otitis media and cholesteatoma. This condition is rarely reported in the recent literature. A very rare case is presented of spontaneous drainage of Bezold’s neck abscess into the middle ear. Pertinent review of the literature is illustrated.

A Case of Acute Mastoiditis Complicated with Epidural Abscess

Received October 31, 2012 Revised January 20, 2013 Accepted January 22, 2013 Address for correspondence Young Ho Kim, MD Department of Otolaryngology, Seoul National University, Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 156-707, Korea Tel +82-2-870-2442 Fax +82-2-870-3863 E-mail yhkiment@gmail.com Epidural abscess is the most common intracranial complication of acute mastoiditis and may lead to a life-threatening condition if an appropriate treatment is not performed. The treatment of choice is a surgical eradication of lesion, drainage of the abscess, and intravenous antibiotic therapy. We report a case of acute mastoiditis followed by an epidural abscess in the posterior cranial fossa in a 32-month male patient. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:516-21 Key WordsZZAcute mastoiditis ᆞEpidural abscess ᆞOtitis media.

Die akute Mastoiditis heute

Acute mastoiditis is an acute inflammation of the mastoid process with bone erosion. It is a complication of acute otitis media, which is rare but with increasing incidence. Distinct characteristics are an erythema and oedematous swelling of the skin of the mastoid process. A fluctuant swelling points to a subperiosteal abscess. Laboratory examination and imaging only support the diagnostics. Therapy involves obligatory systemic antibiotic treatment. At the beginning of the inflammation a paracentesis can be sufficient. A mastoidectomy must be carried out if clear signs of an osseous necrolysis, such as a subperiosteal abscess, are present. The most frequent causative agents are gram positive cocci. Intraoperative smears are best suitable for microbiological diagnostics. Complications of acute mastoiditis are encroachments of the inflammation on neighbouring structures of the mastoid. In such cases a tomography is indicated and therapy is usually surgical.

Acute group A streptococcal mastoiditis complicated by pneumocephaly in a previously healthy adult

Streptococcus pyogenes is a rare cause of mastoiditis in adults. We report a previously healthy adult patient who had acute bacteraemic S. pyogenes mastoiditis complicated by intra-cranial air. This novel report adds pneumocephaly to the currently recognized list of complications of acute mastoiditis.

Postauricular Needle Aspiration of Subperiosteal Abscess in Acute Mastoiditis

To test the hypothesis that subperiosteal abscess, a complication of acute mastoiditis, can be treated equally well by needle aspiration as by cortical mastoidectomy, we performed a retrospective analysis of 78 pediatric patients hospitalized between 1995 and 2003 and performed an analysis of published data on types and outcomes of treatment approaches for acute mastoiditis. Postauricular pus aspiration resolved the subperiosteal abscess in 14 of 17 patients. The length of the hospital stay of patients who underwent aspiration was shorter than that of patients who underwent cortical mastoidectomy. We conclude that postauricular pus aspiration, a simple and minimally invasive procedure, is an effective treatment modality for subperiosteal abscess. Mastoidectomy should be reserved for nonresponsive cases or those with more serious complications. Broad-spectrum antibiotics, myringotomy with daily toilet of the ear, and postauricular aspiration, when required, minimize the indications for surgery and reduce the hospital stay.

Needle aspiration of subperiosteal abscess in acute mastoiditis

Objectives: To test the hypothesis that subperiosteal abscess, a complication of acute mastoiditis, can be treated equally well by pus aspiration as by mastoidectomy. Methods: A retrospective analysis of 62 pediatric patients hospitalized between 1999–2003, and analysis of published data on types and outcomes of treatment approaches for acute mastoiditis. Results: Postauricular pus aspiration resolved the subperiosteal abscess in 13 of 16 patients. The length of hospital stay of patients who underwent aspiration was similar to that of patients who had uncomplicated acute mastoiditis. Conclusions: Postauricular pus aspiration, a simple and minimally invasive procedure, is an effective treatment modality for subperiosteal abscess. Mastoidectomy should be reserved for nonresponsive patients or those with more serious complications. Broad spectrum antibiotics, myringotomy with daily toilet of the ear, and postauricular aspiration, when required, minimize the indications for surgery and reduce hospital stay.

Bacteriology of mastoid subperiosteal abscess in children

ObjectiveSubperiosteal abscess (SA) is the most frequent complication of acute mastoiditis (AM). Of pathogens cultured from the external auditory canal or middle ear during myringotomy, 15% may be different from microorganisms isolated from the SA. We suggest, therefore, that only cultures obtained from the abscess cavity can truly reflect the bacteriology of this complication of AM. The purpose of our study was to analyze the infectious agents which cause SA and mastoid cortex erosion in children.Material and MethodsThe medical records of 35 children who underwent mastoidectomy for SA between May 1984 and April 2002 were evaluated.ResultsMastoid cortex erosion was found at surgery in 72.7% of abscesses Purulent discharge was obtained from the SA cavity in 28 cases. The commonest pathogens isolated in these cases, as well as in 18 cases of mastoid cortex erosion, were Staphylococcus aureus and Streptococcus pyogenes, followed by Streptococcus pneumoniae. Hemophilus influenzae, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae. Sterile culture was found in 25% of cases.ConclusionsMastoid SA is a unilateral disease that can recur. Early administration of anti-Staphylococcus medications should be considered for patients with SA as a complication of AM.

Neues für den praktischen Hals-, Nasen-, Ohrenarzt.

The title might lead one to believe that the author was giving a critical review of what seemed to be new and worthy in the literature of the period covered, which is the past seven years. Instead, what is offered is a series of markedly shrunken abstracts of those articles in the German language, chiefly, which seemed to him noteworthy. As it is, the pamphlet has much merit. There are a good many illustrations, some of them of much interest, taken from the original articles. Among the topics mentioned, all of them, too briefly, are: sepsis following angina; the after-results of tonsillectomy; the surgical anatomy of Ludwig's angina; the pathology and complications of acute mastoiditis; labyrinthitis, and other questions of equal and burning interest to otolaryngologists. The author's idea is excellent; were the work enlarged and the abstracts of important contributions accompanied by critical comment by a man of his

X.: Encephalitis Lethargica as a Postoperative Complication of Acute Mastoiditis with Report of a Case

X.: Encephalitis Lethargica as a Postoperative Complication of Acute Mastoiditis with Report of a Case