Surgical interventions in acute complicated mastoiditis - is a cortical mastoidectomy always required? A 5-year retrospective cohort study.

OBJECTIVES

Anecdotally, surgical intervention for acute complicated mastoiditis within our centre differed between clinicians. We aimed to assess our outcomes and experience.

METHODS

A retrospective observational study was undertaken of children with mastoiditis without intracranial complications admitted between January 2017-September 2022. Electronic records were utilised for data collection. Mann-Whitney U and Chi-square test were used for statistical analysis. Operative intervention, length of stay (LOS), complications and 30 day readmission were analysed.

RESULTS

There were 101 patients with a median age of 2 years and 50 (55 %) were male. Thirty-nine patients (39 %) underwent surgery. Thirty-two patients had mastoiditis with subperiosteal abscess formation without intracranial collections. Seventeen patients (44 %) underwent cortical mastoidectomy (median LOS 5.5 days). Twenty two patients (56 %) underwent incision and drainage (I + D) of abscess plus myringotomy (median LOS 5 days), p = 0.58. The mastoidectomy group had 2 complications and the I + D group had none.

CONCLUSIONS

For mastoiditis with local subperiosteal abscess and no intracranial component, a cortical mastoidectomy may not always be required.