CC BY-NC-ND 4.0 · Laryngorhinootologie 2021; 100(S 02): S252
DOI: 10.1055/s-0041-1728544
Abstracts
Pediatric ENT

Evaluation of clinical and radiological parameters in acute mastoiditis patients to establish a classification with treatment recommendation

SM Häußler
1   Klinik für Hals-Nasen-Ohrenheilkunde, Charité, Berlin
,
K Spierling
1   Klinik für Hals-Nasen-Ohrenheilkunde, Charité, Berlin
,
H Olze
1   Klinik für Hals-Nasen-Ohrenheilkunde, Charité, Berlin
,
K Stölzel
1   Klinik für Hals-Nasen-Ohrenheilkunde, Charité, Berlin
› Author Affiliations
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    Background The primary aim of the study was the evaluation of the clinical outcome of acute mastoiditis (AM) depending on clinical and radiological parameters and the corresponding therapy. Additionally we established a classification that enables suitable and standardized diagnostic and therapy according to the stage of the disease.

    Methods We included 102 pediatric patients in this retrospective study between 06/2008 and 10/2019. A multitude of clinical parameters was evaluated and AM was classified according to clinical and radiological parameters:

    Stage 1: Mastoidal irritation: retroauricular erythema & pain - i.v. antibiotics (AB).

    Stage 2: Beginning AM with apostasis otum, swelling, erythema, no fluctuation of the mastoid region – i.v. AB & adenotomy (AT) & ear tube (ET).

    Stage 3: AM with apostasis otum, swelling, erythema, fluctuation of the mastoid region - CT of the temporal bone – in case of subperiostal abscess/bony erosion – i.v. AB, AT&ET & mastoidectomy.

    Stage 4: AM with further complication (e.g. Bezold’s abscess, epidural empyema) – CT temporal bone & cMRI – extended surgery.

    Results The patient’s (total n=102) mean age was 4.1 years. On the day of hospital admission, patient’s temperature was °C, leukocytes 15.75 /nl and CRP 55.41 mg/l. The most common bacteria was Streptococcus pyogenes (n=29). 95 patients were treated with i.v. AB and additional surgery, hereof 42 with AT&ET and 48 patients with additional mastoidectomy. Three patients had a stage 4 disease.

    Conclusion The classification of AM and the diagnostic and treatment according to the algorithm enable a rapid recovery of the patients. Beginning with AM stage 3, radiological imaging with CT of the temporal bone and additional mastoidectomy is recommended.

    Poster-PDF A-1310.pdf


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    Conflict of interest

    Der Erstautor gibt keinen Interessenskonflikt an.

    Address for correspondence

    Dr. med. Häußler Sophia Marie
    Klinik für Hals-Nasen-Ohrenheilkunde, Charité
    Berlin

    Publication History

    Article published online:
    13 May 2021

    © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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