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Otorhinolaryngology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Chris Jephson, C. Martin Bailey
Mastoiditis occurs when the infection within the middle ear cleft involves the mastoid portion of the temporal bone where it may cause osteitis, erosion and suppuration. The features include fever and inflammatory swelling behind the ear with auricular protrusion (Fig. 19.9). Treatment is with intravenous high-dose broad-spectrum antibiotics with antipseudomonal and staphylococcal activity. Occasionally a cortical mastoidectomy is necessary.
Mastoiditis
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Michael Farnham, Timothy Ketterhagen
Workup may include CBC (complete blood count), inflammatory markers, and blood culture. A temporal bone CT scan should be obtained when mastoiditis is suspected. Prompt intervention with an intravenous broad-spectrum antibiotic is important, along with the drainage of pus from the middle ear and/or mastoid cavity. Complications of mastoiditis include osteomyelitis, nerve palsy, hearing loss, and intracranial extension due to the proximity to the temporal bone. Therefore, prompt intervention is required.
Illustrative patient pathway to self care: cough and colds
Published in Ruth Chambers, Gill Wakley, Alison Blenkinsopp, Supporting Self Care in Primary Care, 2018
Otitis media occurs in around 2% of people with a cold and infection of the paranasal sinuses in around 0.5%.19 Similar dilemmas exist about using antibiotics in these conditions. Antibiotics provide a small benefit for acute otitis media in children. As most cases will resolve spontaneously, this benefit must be weighed against possible adverse reactions.20 Antibiotic treatment may play an important role in reducing the risk of mastoiditis in populations where it is more common.21 The Cochrane review on treatments for maxillary sinusitis in adults found that antibiotics can help some people a bit but will not make a major difference to most.21
New insights into the treatment of acute otitis media
Published in Expert Review of Anti-infective Therapy, 2023
Rana E. El Feghaly, Amanda Nedved, Sophie E. Katz, Holly M. Frost
Patients treated with placebo had a ruptured TM in 4.8% of cases compared to 1.7% of cases in patients treated with antibiotics [83]. Most TM perforations resolve on their own without long-term sequelae. However, hearing loss increased as the size of the perforation increased. Additionally, patients with perforations located posteriorly on the TM had increased hearing loss [130]. Following the development of pneumococcal vaccination, the prevalence of TM perforations as a complication of AOM has decreased [13]. Prior to antibiotics, mastoiditis occurred in approximately 5–10% of patients with AOM and had a mortality rate of 2/100,000 cases. However, after the advent of antibiotics and the pneumococcal vaccine, the incidence of mastoiditis decreased to 2/100,000 cases with a mortality rate of 1/10,000,000 [116].
Application of inner ear MRI after intravenous gadolinium injection in SSNHL
Published in Acta Oto-Laryngologica, 2023
Feng Zhou, Zilin Wang, Yichao Huang, Xi Chen
In this study, the abnormal results of gadolinium contrast magnetic resonance of the inner ear are mainly related to hydrops of the membranous labyrinth and abnormal internal auditory canal, which shows that gadolinium contrast magnetic resonance of the inner ear can be used as an index to detect the cause of sudden deafness. Among the eight patients with abnormal inner ear magnetic resonance imaging, there were seven females and one male. Their average age was 43.6 ± 16.0. At present, no literature has clearly pointed out that there is a certain relationship between age or gender and the incidence rate of sudden hearing loss. However, the interval between onset and treatment, age, the degree of hearing loss, and the presence of vertigo both affect the therapeutic effect and prognosis of sudden hearing loss to some extent [4,10]. Therefore, before the cause was confirmed by gadolinium contrast magnetic resonance of the inner ear, each patient was temporarily treated with oral or tympanic injection of steroids [11]. In this study, two patients with mastoiditis on MRI were considered as aseptic inflammation combined with their medical history, clinical manifestations, and ear endoscopic findings. This type of patient is usually self-healing, so we do not give them other special treatment.
Postero-superior tube in a grooved bone vs. transtympanic tube for middle ear ventilation: a retrospective study comparing outcomes in the Lebanese pediatric population
Published in Acta Oto-Laryngologica, 2022
Elie Bou Sanayeh, Charbel Medawar, Antoine Assaf, Souheil Hallit, Bassam Romanos
Excluded patients were those:Younger than 3 years or older than 12 years of age given that we are exclusively targeting the pediatric population.With history of mastoidectomy or tympanoplasty.With severely damaged TM (perforation, retraction, or tympanosclerosis).With intracranial complications or mastoiditis (given their need for concomitant surgical interventions).With hearing impairment not secondary to OM.With intellectual disabilities and pervasive developmental disorders.Who are defined by the AAO-HNS as having Eustachian tube anatomical variants (craniofacial deformities, Down syndrome, orofacial cleft, or oropharyngeal neoplasm) [9].