Acute mastoiditis in children, a retrospective analysis about a period of 25 years

Background: During the last years the classical signs of the acute mastoiditis have changed. Aim of the following study was to examine the change of symptoms as well as the change of incidence. Methods/Patients: The records of 113 children who received mastoid surgery due to acute mastoiditis were retrospectivly investigated. Data covered a regional group of patients during a period of 25 years (1979 - 2003). Results: Considering the drop of the birthrate from 1991 in the East German countries, there was a significant increase of the incidence of acute mastoiditis. The patients had a mean age of 25 years. The classical symptoms like "retroauricular swelling, tenderness and protrusion of the auricle" were only noted by 47 children (41.6%). Preoperative complications appeared as facial palsy, abscess and septical lateral sinus thrombosis in 11 children. Bacterial cultures, taken during surgery yielded in 55.7% Streptococcus pneumoniae. The therapy contained a surgical intervention combined with antibiotics. Conclusions: An early surgical treatment by mastoidectomy or antrotomy Supported by antibiotics represents the safest method to avoid complications.