Acute mastoidectomy in a Danish county from 1977 to 1997 - operative findings and long-term results

Data from patients undergoing acute mastoidectomy were examined retrospecti vely to evaluate if the nature of acute mastoiditis (AM) treated surgically has changed during the last 20 years (1977-97). Moreover, a prevalence stu dy was conducted to clarify the otological and audiological course followin g acute mastoidectomy. Patients with cholesteatoma and intracranial complic ations were excluded. Thus, 79 patients with a median age of 16 months were included. Thirty-seven percent had a history of middle ear disease, and th e mean duration from onset of symptoms to admission was 9 days. Well-being was affected in 46%, and 82% had fever. The clinical picture was dominated by auricular protrusion (77%) and pathological tympanic membrane (94%). Pos tauricular oedema, hyperaemia and tenderness were demonstrated in 89%, 78% and 49% of cases, respectively. Peroperatively, purulent middle ear effusio n was recognized in 92%, subperiosteal abscess in 6% and pus in the mastoid in 90%. Specimens revealed growth of pathogens in 58%, predominantly Gram- positive bacteria. The observation period was 1-20 years. The findings in o perated ears were not significantly different from the contralateral non-op erated ears concerning incidence of otitis media, hearing and ear canal vol ume. Conclusively, acute mastoidectomy is a safe and effective treatment to eliminate infection. The operation can be dune with negligible risk and do es not leave long-term sequelae.