The Laryngoscope · 2025
The Significance of Subperiosteal Abscess Volume in Acute Mastoiditis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Abu-Eta Rani, Salameh Ramez, Oron Yahav, Handzel Ophir, Muhanna Nidal, Ungar Omer Jacob
Аннотация
OBJECTIVE: To determine whether the subperiosteal abscess (SPA) volume in acute coalescent mastoiditis (ACM) as measured in imaging studies, should influence the decision-making process between performing mastoidectomy versus needle aspiration or incision and drainage (I&D) as the initial treatment of SPA.
SETTING: Single tertiary referral center.
PATIENTS AND METHODS: The records of all pediatric patients admitted with ACM between 1/2012 and 12/2023 were retrospectively reviewed. Baseline abscess volumes were measured on dedicated segmentation software for analyzing imaging findings. SPA volumes of needle aspirations were compared with those following I&D. Outcomes were compared.
RESULTS: In total, 99 patients (median [interquartile range] age 26 [11-35] months) were enrolled. The mean ± standard deviation white blood cell (WBC) counts and C-reactive protein (CRP) levels were 14.5 ± 7.0 K/μL and 112 ± 42 mg/dL, respectively. Fifty-seven patients were treated by needle aspiration and 42 by I&D. Age, WBC counts, and CRP levels were similar for both groups, as were SPA volumes as seen on imaging studies 2.0 ± 1.0 cm3 for the former group and 2.0 ± 0.9 cm3 for the latter group (p = 0.955). Resolution rates were 75.4% and 76.2%, respectively (p = 0.931). Resolved SPAs after needle aspiration and I&D had similar volumes 1.7 ± 0.9 and 1.7 ± 0.7 cm3, respectively, p = 0.931.
CONCLUSION: Both needle aspiration and I&D are safe methods to reduce the infective and inflammatory load and provide pus for culture. Higher volumes (~3 cm3 and more) should be managed initially with cortical mastoidectomy since the risk of no improvement following needle aspiration or I&D is higher.
SETTING: Single tertiary referral center.
PATIENTS AND METHODS: The records of all pediatric patients admitted with ACM between 1/2012 and 12/2023 were retrospectively reviewed. Baseline abscess volumes were measured on dedicated segmentation software for analyzing imaging findings. SPA volumes of needle aspirations were compared with those following I&D. Outcomes were compared.
RESULTS: In total, 99 patients (median [interquartile range] age 26 [11-35] months) were enrolled. The mean ± standard deviation white blood cell (WBC) counts and C-reactive protein (CRP) levels were 14.5 ± 7.0 K/μL and 112 ± 42 mg/dL, respectively. Fifty-seven patients were treated by needle aspiration and 42 by I&D. Age, WBC counts, and CRP levels were similar for both groups, as were SPA volumes as seen on imaging studies 2.0 ± 1.0 cm3 for the former group and 2.0 ± 0.9 cm3 for the latter group (p = 0.955). Resolution rates were 75.4% and 76.2%, respectively (p = 0.931). Resolved SPAs after needle aspiration and I&D had similar volumes 1.7 ± 0.9 and 1.7 ± 0.7 cm3, respectively, p = 0.931.
CONCLUSION: Both needle aspiration and I&D are safe methods to reduce the infective and inflammatory load and provide pus for culture. Higher volumes (~3 cm3 and more) should be managed initially with cortical mastoidectomy since the risk of no improvement following needle aspiration or I&D is higher.