Acute mastoiditis in children: is surgical treatment necessary?

Acute mastoiditis in children remains an otological problem. Although the w idespread use of antibiotics has reduced the need for surgical intervention , surgery is frequently used in the treatment of acute mastoiditis and its complications. The charts of 44 patients hospitalized with signs of acute m astoiditis were reviewed. In 43.2 per cent of all patients, acute mastoidit is was the presenting sign of acute middle-ear infection. Post-auricular er ythema and protrusion Of the auricle were the most frequent signs at presen tation. All four signs (post-auricular erythema, oedema, tenderness, and pr otrusion of the auricle) were present in 40.9 per cent of patients. No bact erial pathogen was isolated in 45.5 per cent of ear cultures. Complicated a cute mastoiditis was diagnosed in 13.7 per cent: of the patients. Eighty-se ven per cent of patients responded well to intravenous antibiotics and myri ngotomy, and in 11.4 per cent mastoidectomy or abscess drainage were perfor med. We conclude that nearly all patients with uncomplicated mastoiditis re cover following intravenous antibiotics and myringotomy. Mastoidectomy shou ld be: performed in selected cases, such as cases of complicated acute mast oiditis.