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Mastoid subperiosteal abscess in children: drainage or mastoidectomy?

Published online by Cambridge University Press:  26 October 2012

I Psarommatis ,
P Giannakopoulos ,
E Theodorou ,
C Voudouris ,
C Carabinos  and
M Tsakanikos
I Psarommatis*
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
P Giannakopoulos
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
E Theodorou
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
C Voudouris
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
C Carabinos
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
M Tsakanikos
Affiliation:
ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Greece
*
Address for correspondence: Dr Ioannis Psarommatis, ENT Department, ‘P & A Kyriakou’ Children's Hospital of Athens, Thivon & Levadias St, 11527 Goudi, Athens, Greece E-mail: [email protected]
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Abstract

Objective:

To evaluate the management of mastoid subperiosteal abscess using two different surgical approaches: simple mastoidectomy and abscess drainage.

Method:

The medical records of 34 children suffering from acute mastoiditis with subperiosteal abscess were retrospectively reviewed. In these cases, the initial surgical approach consisted of either myringotomy plus simple mastoidectomy or myringotomy plus abscess drainage.

Results:

Thirteen children were managed with simple mastoidectomy and 21 children were initially managed with abscess drainage. Of the second group, 12 children were cured without further treatment while 9 eventually required mastoidectomy. None of the children developed complications during hospitalisation, or long-term sequelae.

Conclusion:

Simple mastoidectomy remains the most effective procedure for the management of mastoid subperiosteal abscess. Drainage of the abscess represents a simple and risk-free, but not always curative, option. It can be safely used as an initial, conservative approach in association with myringotomy and sufficient antibiotic coverage, with simple mastoidectomy reserved for non-responding cases.

Keywords

MastoiditisAbscessComplicationsChildDisease ManagementMastoidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 12 , December 2012 , pp. 1204 - 1208
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented in part (2002–2009 data) at the 10th International Congress of the European Society of Pediatric Otorhinolaryngology, 5–8 June 2010, Pamplona, Spain

References

1Luntz, M, Brodsky, A. Acute mastoiditis. In: Alper, C, Bluestone, C, Casselbrant, M, Dohar, J, Mandell, E, eds. Advanced Therapy of Otitis Media. Hamilton, Ontario: BC Decker, 2004;325–9Google Scholar
2Gliklich, RE, Eavey, RD, Iannuzzi, RA, Camacho, AE. A contemporary analysis of acute mastoiditis. Arch Otolaryngol Head Neck Surg 1996;122:135–9CrossRefGoogle ScholarPubMed
3Goldstein, NA, Casselbrant, ML, Bluestone, CD, Kurs-Lasky, M. Intratemporal complications of acute otitis media in infants and children. Otolaryngol Head Neck Surg 1998;119:444–54CrossRefGoogle ScholarPubMed
4Neely, JG. Surgery of acute infections and their complications. In: Brackmann, DE, Shelton, C, Arriaga, MA, eds. Otologic Surgery, 3rd edn.Philadelphia: Saunders-Elsevier, 2010;183–94CrossRefGoogle Scholar
5Bauer, PW, Brown, KR, Jones, DT. Mastoid subperiosteal abscess management in children. Int J Pediatr Otorhinolaryngol 2002;63:185–8CrossRefGoogle ScholarPubMed
6Taylor, MF, Berkowitz, RG. Indications for mastoidectomy in acute mastoiditis in children. Ann Otol Rhinol Laryngol 2004;113:69–72CrossRefGoogle ScholarPubMed
7Lahav, J, Handzel, O, Yehuda, M, Halperin, D. Postauricular needle aspiration of subperiosteal abscess in acute mastoiditis. Ann Otol Rhinol Laryngol 2005;114:323–7CrossRefGoogle ScholarPubMed
8Hawkins, DB, Dru, D. Mastoid subperiosteal abscess. Arch Otolaryngol 1983;109:369–71CrossRefGoogle ScholarPubMed
9Khafif, A, Halperin, D, Hochman, I, Gertler, R, Poria, I, Shindel, D et al. Acute mastoiditis: a 10-year review. Am J Otolaryngol 1998;19:170–3CrossRefGoogle Scholar
10Luntz, M, Brodsky, A, Nusem, S, Kronenberg, J, Keren, G, Migirov, L et al. Acute mastoiditis – the antibiotic era: a multicenter study. Int J Pediatr Otorhinolaryngol 2001;57:1–9CrossRefGoogle ScholarPubMed
11Hawkins, DB, Dru, D, House, JWClark, RW. Acute mastoiditis in children: a review of 54 cases. Laryngoscope 1983;93:568–72CrossRefGoogle ScholarPubMed
12Mallur, PS, Harirchian, S, Lalwani, AK. Preoperative and postoperative intracranial complications of acute mastoiditis. Ann Otol Rhinol Laryngol 2009;118:118–23CrossRefGoogle ScholarPubMed
13Vera-Cruz, P, Roque Farinha, R, Calado, V. Acute mastoiditis in children – our experience. Int J Pediatr Otorhinolaryngol 1999;50:113–17CrossRefGoogle ScholarPubMed
14Tamir, S, Shwartz, Y, Peleg, U, Shaul, C, Perez, R, Sichel, J. Shifting trends: mastoiditis from a surgical to a medical disease. Am J Otolaryngol 2010;31:467–71CrossRefGoogle ScholarPubMed
15Migirov, L, Yakirevitch, A, Kronenberg, J. Mastoid subperiosteal abscess: a review of 51 cases. Int J Pediatr Otorhinolaryngol 2005;69:1529–33CrossRefGoogle ScholarPubMed
16Bales, CB, Sobol, S, Wetmore, R, Elden, LM. Lateral sinus thrombosis as a complication of otitis media: 10-year experience at the children's hospital of Philadelphia. Pediatrics 2009;123:709–13CrossRefGoogle ScholarPubMed
17Christensen, N, Wayman, J, Spencer, J. Lateral sinus thrombosis: a review of seven cases and proposal of a management algorithm. Int J Pediatr Otorhinolaryngol 2009;73:581–5CrossRefGoogle ScholarPubMed
18Quesnel, S, Nguyen, M, Pierrot, S, Contencin, P, Manach, Y, Couloigner, V. Acute mastoiditis in children: a retrospective study of 188 patients. Int J Pediatr Otorhinolaryngol 2010;74:1388–92CrossRefGoogle ScholarPubMed