International journal of pediatric otorhinolaryngology · 2026
Contemporary management of paediatric acute mastoiditis in Aotearoa New Zealand.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Noakes Annabel, Stevenson Jonathan, Bird Philip, Hale Samuel, Rowlands Stephen, Kong Leon, Keren Benjamin, Benoiton Lara
Аннотация
BACKGROUND: There has been a recent increase in the incidence of paediatric acute mastoiditis (AM) with a global trend towards more conservative management strategies. Our aim was to evaluate the contemporary management of paediatric AM in Aotearoa New Zealand.
METHODOLOGY: A retrospective observational study including AM patients aged <18 years treated in five tertiary hospitals across Aotearoa New Zealand between 2014 and 2022.
RESULTS: There were 212 cases of AM with 104 cases (49%) of uncomplicated AM and 108 cases (51%) of complicated AM. Complications included 75 cases (35%) of sub-periosteal abscess (SPA), 18 cases (8%) of meningitis or intra-cranial abscess, 21 cases (10%) of venous sinus thrombosis and 6 cases (3%) of petrous apicitis. 54 (52%) of uncomplicated AM cases were managed with medical therapy, 42 (40%) with conservative surgery and 8 (8%) with mastoidectomy. Additional surgery was required in 13 (13%) cases. Median length of stay was 3 days (range 1-23 days). 30 day unplanned readmissions occurred in 7 (7%) cases. There were no cases of recurrent AM. There were no significant differences in outcomes between treatment strategies. 40 (53%) of SPA cases were managed with incision and drainage/aspiration and 24 (33%) were managed with mastoidectomy. There was no significant difference in the proportion of cases requiring additional surgery.
CONCLUSIONS: Conservative treatment strategies, including medical management or conservative surgery for uncomplicated AM and incision and drainage for SPA cases, may be considered in cases of paediatric AM.
METHODOLOGY: A retrospective observational study including AM patients aged <18 years treated in five tertiary hospitals across Aotearoa New Zealand between 2014 and 2022.
RESULTS: There were 212 cases of AM with 104 cases (49%) of uncomplicated AM and 108 cases (51%) of complicated AM. Complications included 75 cases (35%) of sub-periosteal abscess (SPA), 18 cases (8%) of meningitis or intra-cranial abscess, 21 cases (10%) of venous sinus thrombosis and 6 cases (3%) of petrous apicitis. 54 (52%) of uncomplicated AM cases were managed with medical therapy, 42 (40%) with conservative surgery and 8 (8%) with mastoidectomy. Additional surgery was required in 13 (13%) cases. Median length of stay was 3 days (range 1-23 days). 30 day unplanned readmissions occurred in 7 (7%) cases. There were no cases of recurrent AM. There were no significant differences in outcomes between treatment strategies. 40 (53%) of SPA cases were managed with incision and drainage/aspiration and 24 (33%) were managed with mastoidectomy. There was no significant difference in the proportion of cases requiring additional surgery.
CONCLUSIONS: Conservative treatment strategies, including medical management or conservative surgery for uncomplicated AM and incision and drainage for SPA cases, may be considered in cases of paediatric AM.