MASTOIDITIS IN CHILDREN

Background Despite new antibiotics mastoiditis in children still is a serious infection confronting the pediatrician and otolaryngologist wi th diagnostic and therapeutic problems. Patients and Methods In a retr ospective study we reviewed the charts of 48 children who had a mastoi dectomy from 1990 to 1995 in the Department of Oto-Rhino-Laryngology a t the University of Essen. Results 60% of the patients presented with a retroauricular swelling, and a pathologic tympanic membrane was foun d in 89%. The erythrocyte sedimentation rate as the most valuable labo ratory parameter was increased in 95% of cases. Larger osteodestructiv e lesions as a complication of mastoiditis could be predicted in three of ten cases by plain x-ray of the temporal bone. The most common bac teria to be isolated were Staphylococcus aureus, Streptococcus pneumon iae and Pseudomonas aeruginosa. Conclusion Because of potential endocr anial complications (10% in our patients) as well as difficult radiolo gic diagnosis of osteodestructive lesions by plain x-ray, we advocate mastoidectomy instead of a mere pharmacological therapy in the treatme nt of mastoiditis.