2.4 Department AM protocol
Generally, children presenting with AM are hospitalized and treated with
intravenous antibiotics. A wide myringotomy is performed at admission
(under local anesthesia), and culture is obtained from the middle ear.
When CAM is suspected clinically (persistent fever and lack of
improvement/deterioration in clinical findings), the patient is
evaluated by a head and temporal bone high-resolution computerized
tomography with contrast material. Once imaging reveals the presence of
a complication, surgery is planned, which includes a cortical
mastoidectomy and insertion of an ipsilateral ventilation tube (VT). In
cases of peri-sinus abscesses, drainage and bony decompression of the
sinus is performed. Anticoagulants are administered for three months in
cases of SST cases and the patient is followed with repeated head MRIs.