Paediatric acute mastoiditis: the Alder Hey experience

Abstract

Acute mastoiditis was a common condition in the pre-antibiotic era, but has become rare now with the widespread use of antibiotics.

A retrospective study was carried out of patients with acute mastoiditis who were seen at Alder Hey Children’s Hospital, Liverpool over a five-year period. Their case records were identified and details of gender, age at presentation, symptoms, signs and clinical management were noted and analysed.

Twenty-one patients who presented with acute mastoiditis were identified. The patients’ age at presentation ranged from three months to 14 years. Five cases out of 21 (23.8 per cent) were under one year of age.Eighteen cases (85.7 per cent) presented with post-aural swelling while 12 (57.1 per cent) had aural discharge.

All patients were treated with intravenous antibiotics and only five patients (23.8 per cent) required surgical intervention in the form of a cortical mastoidectomy with, or without, myringotomy.

A significant number of cases can be treated conservatively with intravenous antibiotics. Surgery in the form of cortical mastoidectomy can be reserved for complicated cases and in those in whom conservative treatment has failed.