1. Introduction
Acute mastoiditis (AM) is a complication of acute otitis media and is common in the pediatric population (1-3). Management is usually conservative and includes performing a wide myringotomy, middle ear fluid (MEF) cultures, and parenteral administring antibiotics. Patients who develop complications or do not respond to treatment will most often undergo diagnostic imaging and a cortical mastoidectomy (1,2, 4).
The most common complications seen in children with AM are a sub-periosteal abscess (SPA), sigmoid sinus thrombosis (SST), peri-sinus fluid/abscess, epidural/subdural abscess, and acute meningitis. These complications are diagnosed clinically and radiologically(5). Surgery with ventilation tube insertion, has a vital role in treating complicated mastoiditis, along with antibiotics(6), antipyretics, and anticoagulation, in cases of SST (7).
The management of a febrile child with CAM whether with or without clinical improvement becomes challenging. In such cases, repeated imaging and revision surgery and would be considered. On the other hand, imaging in such circumstances possesses several limitations; At a young age post-contrast head CT usually requires general anesthesia and is associated with substantial ionizing radiation. Head MRI is superior for evaluating soft tissue details such as of peri-sinus abscess and presence of SST but is less available, is costly, and requires an extended general anesthesia period.
The main aim of the present study was to characterize the immediate follow-up of children with CAM following surgery, regarding the post-operative fever (POF), the inflammatory parameters and to define the microbiology.
2. Materials and methodsIn this cohort retrospective study we followed STROBE methodology Guidelines.