Mastoiditis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
==Natural History | ==Natural History== | ||
Without treatment, the patient will develop sever complication, which may eventually lead to brain infection complications and death. | |||
== Complications == | |||
The consequences of mastoiditis have been reduced after introduction of antimicrobial agents and adequate therapy of acute otitis media. However mastoiditis has not been omitted completely and may give rise to sever complications. The incidence of mastoiditis complications are differs from 4% to 16.6% in the multiple studies.<ref name="pmid10767461">{{cite journal |vauthors=Go C, Bernstein JM, de Jong AL, Sulek M, Friedman EM |title=Intracranial complications of acute mastoiditis |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=52 |issue=2 |pages=143–8 |year=2000 |pmid=10767461 |doi= |url=}}</ref><ref name="pmid14551488">{{cite journal |vauthors=Katz A, Leibovitz E, Greenberg D, Raiz S, Greenwald-Maimon M, Leiberman A, Dagan R |title=Acute mastoiditis in Southern Israel: a twelve year retrospective study (1990 through 2001) |journal=Pediatr. Infect. Dis. J. |volume=22 |issue=10 |pages=878–82 |year=2003 |pmid=14551488 |doi=10.1097/01.inf.0000091292.24683.fc |url=}}</ref><ref name="pmid15757196">{{cite journal |vauthors=Oestreicher-Kedem Y, Raveh E, Kornreich L, Popovtzer A, Buller N, Nageris B |title=Complications of mastoiditis in children at the onset of a new millennium |journal=Ann. Otol. Rhinol. Laryngol. |volume=114 |issue=2 |pages=147–52 |year=2005 |pmid=15757196 |doi=10.1177/000348940511400212 |url=}}</ref><ref name="pmid17493691">{{cite journal |vauthors=Benito MB, Gorricho BP |title=Acute mastoiditis: increase in the incidence and complications |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=71 |issue=7 |pages=1007–11 |year=2007 |pmid=17493691 |doi=10.1016/j.ijporl.2007.02.014 |url=}}</ref> | The consequences of mastoiditis have been reduced after introduction of antimicrobial agents and adequate therapy of acute otitis media. However mastoiditis has not been omitted completely and may give rise to sever complications. The incidence of mastoiditis complications are differs from 4% to 16.6% in the multiple studies.<ref name="pmid10767461">{{cite journal |vauthors=Go C, Bernstein JM, de Jong AL, Sulek M, Friedman EM |title=Intracranial complications of acute mastoiditis |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=52 |issue=2 |pages=143–8 |year=2000 |pmid=10767461 |doi= |url=}}</ref><ref name="pmid14551488">{{cite journal |vauthors=Katz A, Leibovitz E, Greenberg D, Raiz S, Greenwald-Maimon M, Leiberman A, Dagan R |title=Acute mastoiditis in Southern Israel: a twelve year retrospective study (1990 through 2001) |journal=Pediatr. Infect. Dis. J. |volume=22 |issue=10 |pages=878–82 |year=2003 |pmid=14551488 |doi=10.1097/01.inf.0000091292.24683.fc |url=}}</ref><ref name="pmid15757196">{{cite journal |vauthors=Oestreicher-Kedem Y, Raveh E, Kornreich L, Popovtzer A, Buller N, Nageris B |title=Complications of mastoiditis in children at the onset of a new millennium |journal=Ann. Otol. Rhinol. Laryngol. |volume=114 |issue=2 |pages=147–52 |year=2005 |pmid=15757196 |doi=10.1177/000348940511400212 |url=}}</ref><ref name="pmid17493691">{{cite journal |vauthors=Benito MB, Gorricho BP |title=Acute mastoiditis: increase in the incidence and complications |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=71 |issue=7 |pages=1007–11 |year=2007 |pmid=17493691 |doi=10.1016/j.ijporl.2007.02.014 |url=}}</ref> | ||
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{| class="wikitable" | {| class="wikitable" | ||
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| rowspan=" | | rowspan="6" |'''Extracranial complications''' | ||
|'''Osteomyelitis''' | |'''[[Osteomyelitis]]''' | ||
|Mastoid infection may spread to other parts of the skull which leads to osteomyelitis. | |Mastoid infection may spread to other parts of the skull which leads to osteomyelitis. | ||
Petrositis is petrous bone osteomyelitis, which could be as a part of Gradenigo’s syndrome (retro-orbital pain, otorrhea, abducens nerve palsy, and acute or chronic otitis media) | Petrositis is petrous bone osteomyelitis, which could be as a part of Gradenigo’s syndrome (retro-orbital pain, otorrhea, abducens nerve palsy, and acute or chronic otitis media) | ||
|- | |- | ||
|'''Labyrinthitis''' | |'''[[Labyrinthitis]]''' | ||
|Inflammation or infection of the bony part of labyrinth could cause labyrinthitis. Sensorineural hearing loss, tinnitus, vomiting, vertigo, and spontaneous nystagmus clinical symptoms diagnosis | |Inflammation or infection of the bony part of labyrinth could cause labyrinthitis. Sensorineural hearing loss, tinnitus, vomiting, vertigo, and spontaneous nystagmus clinical symptoms diagnosis | ||
|- | |- | ||
|'''Facial nerve palsy''' | |'''[[Facial nerve palsy]]''' | ||
|May occur when the facial nerve passes throw the canal in the petrous part of temporal bone | |May occur when the facial nerve passes throw the canal in the petrous part of temporal bone | ||
|- | |- | ||
|''' | |'''[[Bezold abscess]]''' | ||
|This abscess is a neck abscess under the digastric and sternocleidomastoid muscles. Clinical features of Bezold abscess include swelling and tenderness below the mastoid process and below the sternocleidomastoid muscle.<ref name="pmid15967073">{{cite journal |vauthors=Leskinen K |title=Complications of acute otitis media in children |journal=Curr Allergy Asthma Rep |volume=5 |issue=4 |pages=308–12 |year=2005 |pmid=15967073 |doi= |url=}}</ref> | |This abscess is a neck abscess under the digastric and sternocleidomastoid muscles. Clinical features of Bezold abscess include swelling and tenderness below the mastoid process and below the sternocleidomastoid muscle.<ref name="pmid15967073">{{cite journal |vauthors=Leskinen K |title=Complications of acute otitis media in children |journal=Curr Allergy Asthma Rep |volume=5 |issue=4 |pages=308–12 |year=2005 |pmid=15967073 |doi= |url=}}</ref> | ||
|- | |- | ||
|'''Hearing loss''' | |'''[[Hearing loss]]''' | ||
|Acute mastoiditis can cause hearing loss because of middle ear effusion or external auditory canal obstruction. This condition can be transient and resolves with appropriate treatment. However in some situation hearing loss may be permanent, such as middle ear ossicles damage or cochlea damage due to suppurative labyrinthitis. | |Acute mastoiditis can cause hearing loss because of middle ear effusion or external auditory canal obstruction. This condition can be transient and resolves with appropriate treatment. However in some situation hearing loss may be permanent, such as middle ear ossicles damage or cochlea damage due to suppurative labyrinthitis. | ||
|- | |- | ||
|'''Subperiosteal abscess''' | |'''[[Subperiosteal abscess]]''' | ||
|Fluctuation, erythema and a tender mass overlying the mastoid bone are clinical clues to diagnosis of this complication. | |Fluctuation, erythema and a tender mass overlying the mastoid bone are clinical clues to diagnosis of this complication. | ||
|- | |- | ||
| rowspan="4" |'''Intracranial complications''' | | rowspan="4" |'''Intracranial complications''' | ||
|'''Epidural and subdural abscess''' | |'''[[Epidural and subdural abscess]]''' | ||
| rowspan="4" | | | rowspan="4" |Fever, otalgia, cephalgia are general clinical features. An altered mental status along with an otitis media may also be a sign of intracranial complication. | ||
|- | |- | ||
|'''Meningitis''' | |'''[[Meningitis]]''' | ||
|- | |- | ||
|'''Temporal bone or brain abscess''' | |'''[[Temporal bone or brain abscess]]''' | ||
|- | |- | ||
|'''Venous sinus thrombosis''' | |'''[[Venous sinus thrombosis]]''' | ||
|} | |} | ||
== | ==Prognosis== | ||
The prognosis of mastoiditis is good with treatment. Excellent outcomes may be expected for those who are managed without delay. | |||
Children with acute mastoiditis should be managed in centres where timely and complete medical and surgical treatment is available. | |||
== | Without treatment, will result in cerebral complications.<ref name="pmid19758711">{{cite journal |vauthors=Pang LH, Barakate MS, Havas TE |title=Mastoiditis in a paediatric population: a review of 11 years experience in management |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=73 |issue=11 |pages=1520–4 |year=2009 |pmid=19758711 |doi=10.1016/j.ijporl.2009.07.003 |url=}}</ref> | ||
= | |||
====== | |||
. | |||
==References== | ==References== | ||
Revision as of 16:44, 26 June 2017
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Mastoiditis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Natural History
Without treatment, the patient will develop sever complication, which may eventually lead to brain infection complications and death.
Complications
The consequences of mastoiditis have been reduced after introduction of antimicrobial agents and adequate therapy of acute otitis media. However mastoiditis has not been omitted completely and may give rise to sever complications. The incidence of mastoiditis complications are differs from 4% to 16.6% in the multiple studies.[1][2][3][4]
mastoiditis complication may be classified to extracranial and intracranial as in below table: [1][5][6][7]
| Extracranial complications | Osteomyelitis | Mastoid infection may spread to other parts of the skull which leads to osteomyelitis.
Petrositis is petrous bone osteomyelitis, which could be as a part of Gradenigo’s syndrome (retro-orbital pain, otorrhea, abducens nerve palsy, and acute or chronic otitis media) |
| Labyrinthitis | Inflammation or infection of the bony part of labyrinth could cause labyrinthitis. Sensorineural hearing loss, tinnitus, vomiting, vertigo, and spontaneous nystagmus clinical symptoms diagnosis | |
| Facial nerve palsy | May occur when the facial nerve passes throw the canal in the petrous part of temporal bone | |
| Bezold abscess | This abscess is a neck abscess under the digastric and sternocleidomastoid muscles. Clinical features of Bezold abscess include swelling and tenderness below the mastoid process and below the sternocleidomastoid muscle.[8] | |
| Hearing loss | Acute mastoiditis can cause hearing loss because of middle ear effusion or external auditory canal obstruction. This condition can be transient and resolves with appropriate treatment. However in some situation hearing loss may be permanent, such as middle ear ossicles damage or cochlea damage due to suppurative labyrinthitis. | |
| Subperiosteal abscess | Fluctuation, erythema and a tender mass overlying the mastoid bone are clinical clues to diagnosis of this complication. | |
| Intracranial complications | Epidural and subdural abscess | Fever, otalgia, cephalgia are general clinical features. An altered mental status along with an otitis media may also be a sign of intracranial complication. |
| Meningitis | ||
| Temporal bone or brain abscess | ||
| Venous sinus thrombosis |
Prognosis
The prognosis of mastoiditis is good with treatment. Excellent outcomes may be expected for those who are managed without delay.
Children with acute mastoiditis should be managed in centres where timely and complete medical and surgical treatment is available.
Without treatment, will result in cerebral complications.[9]
References
- ↑ 1.0 1.1 Go C, Bernstein JM, de Jong AL, Sulek M, Friedman EM (2000). "Intracranial complications of acute mastoiditis". Int. J. Pediatr. Otorhinolaryngol. 52 (2): 143–8. PMID 10767461.
- ↑ Katz A, Leibovitz E, Greenberg D, Raiz S, Greenwald-Maimon M, Leiberman A, Dagan R (2003). "Acute mastoiditis in Southern Israel: a twelve year retrospective study (1990 through 2001)". Pediatr. Infect. Dis. J. 22 (10): 878–82. doi:10.1097/01.inf.0000091292.24683.fc. PMID 14551488.
- ↑ Oestreicher-Kedem Y, Raveh E, Kornreich L, Popovtzer A, Buller N, Nageris B (2005). "Complications of mastoiditis in children at the onset of a new millennium". Ann. Otol. Rhinol. Laryngol. 114 (2): 147–52. doi:10.1177/000348940511400212. PMID 15757196.
- ↑ Benito MB, Gorricho BP (2007). "Acute mastoiditis: increase in the incidence and complications". Int. J. Pediatr. Otorhinolaryngol. 71 (7): 1007–11. doi:10.1016/j.ijporl.2007.02.014. PMID 17493691.
- ↑ Minovi A, Dazert S (2014). "Diseases of the middle ear in childhood". GMS Curr Top Otorhinolaryngol Head Neck Surg. 13: Doc11. doi:10.3205/cto000114. PMC 4273172. PMID 25587371.
- ↑ Pellegrini S, Gonzalez Macchi ME, Sommerfleck PA, Bernáldez PC (2012). "Intratemporal complications from acute otitis media in children: 17 cases in two years". Acta Otorrinolaringol Esp. 63 (1): 21–5. doi:10.1016/j.otorri.2011.06.007. PMID 21982482.
- ↑ van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG (2008). "A systematic review of diagnostic criteria for acute mastoiditis in children". Otol. Neurotol. 29 (6): 751–7. doi:10.1097/MAO.0b013e31817f736b. PMID 18617870.
- ↑ Leskinen K (2005). "Complications of acute otitis media in children". Curr Allergy Asthma Rep. 5 (4): 308–12. PMID 15967073.
- ↑ Pang LH, Barakate MS, Havas TE (2009). "Mastoiditis in a paediatric population: a review of 11 years experience in management". Int. J. Pediatr. Otorhinolaryngol. 73 (11): 1520–4. doi:10.1016/j.ijporl.2009.07.003. PMID 19758711.