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.