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  Patronage of the Polish Society of Audiology and Phoniatrics

vol 11. no 1. March 2012  

 Original articles
Acute mastoiditis with subperiosteal abscess in children
Agnieszka Krajewska, Małgorzata Śmiechura, Małgorzata Strużycka, Agata Makowska-Piontek, Wiesław Konopka

Introduction. Mastoiditis is defined as the inflammatory process
affecting pneumatic cells of the mastoid bone with symptoms
of bone inflammation. Since the introduction of efficient oral
antibiotic treatment, mastoiditis has become less frequent, while
it continues to be a grave complication of otitis media and its
consequences may be even fatal.
Aim. The aim of the work is to present the cases of rapidly
progressing mastoiditis with subperiosteal abscess in children
without prior medical history of otitis media.
Material and methods. A group of three cases of acute mastoiditis
in children hospitalised during three consecutive months.
Results. The children, 2-5 years old, were in different general
condition at the moment of admission to the clinic: two were
without otorrhoea and with non-perforated tympanum.
Changes in the auricle region (red and swollen skin, fluctuating
abscess) were evident in all cases. Antromastoidectomy was
urgently performed in all of the children, followed by extensive
drainage of the postoperative cavity, incision of the tympanic
membane and provision of a ventilation drain. The surgery
was supplemented with intravenous antibiotic and steroid
treatment. Streptococcus pyogenes was cultured in one case,
and Streptococcus pneumoniae was cultured in two cases in
the culture medium inoculated with the pus collected from the
mastoid bone. The treatment was successful in all patients.
Conclusions. Intact tympanic membrane in acute otitis media
does not exclude possible complications. Such complications
require urgent surgical intervention supplemented with antibiotic

keywords: ostre zapalenie ucha środkowego, zapalenie wyrostka sutkowego, powikłania, antromastoidektomia, bakteriologia, acute otitis media, mastoiditis, complication, antromastoidectomy, bacteriology

pages: from 22 to 26

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