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Acta Bio-medica : Atenei Parmensis Feb 2020Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects... (Review)
Review
Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects very young children with severe clinical course and sometimes causes serious complications. Most important risk factors are the young age (often>2 years), high fever, alteration of the laboratory findings (very high values of WBC count, absolute neutrophil count and C-reactive protein), while less important are previous antibiotic therapy or previous middle ear infections. The main pathogen of the acute mastoiditis is Streptococcus pneumoniae, followed by Streptococcus piogenes, Haemophilus influentiae, and Staphylococcus aureus. The finding of Pseudomonas aeruginosa is not uncommon, but often its presence is often considered a contamination or simultaneous infection. The complications can be extracranial (subperiosteal abscess, Bezold's abscess); intratemporal (facial nerve palsy, labyrinthitis) and intracranial (subdural abscess). The complications have often a very serious clinical course and potentially life-threatening. Antibiotic therapy is the main treatment in not complicated forms. Considering the prevalence of Streptococcus pneumoniae, cephalosporins are the antibiotic of choice, but they have to be administrated intravenously in hospitalized patients. Combinations with other antibiotic are suggested when multibacterial flora is present. In complicated forms of acute mastoiditis, the antibiotic treatment can be particularly important, in combination with other specific drugs (i.e. anticoagulants and/or corticosteroids). Surgical treatments, such as incision of abscesses, mastoidectomy, and neurosurgical procedures, are sometimes performed in combination with medical therapy in very severe complications. Data from our experience are briefly reported.
Topics: Acute Disease; Anti-Bacterial Agents; Child; Humans; Mastoiditis
PubMed: 32073562
DOI: 10.23750/abm.v91i1-S.9259 -
Ear, Nose, & Throat Journal May 2022We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy...
We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy presented due to 1 month of a pronounced left ulcerative mastoid lesion. Strikingly, there were no cranial nerve deficits which was unexpected due to the degree of the lesion. Initially, infectious mastoiditis was suspected based on physical examination alone. Due to the patient being a poor historian, it was difficult to determine whether this was an acute or chronic issue. Temporal bone squamous cell carcinoma, infectious mastoiditis, and actinomycosis were on the differential, but biopsies revealed non-Hodgkin lymphoma.
Topics: Actinomycosis; Aged; Diagnosis, Differential; Humans; Lymphoma, Non-Hodgkin; Male; Mastoid; Mastoiditis; Temporal Bone
PubMed: 32841094
DOI: 10.1177/0145561320950493 -
The Journal of International Advanced... Jul 2022Congenital cholesteatomas account for just up to 5% of all cholesteatomas and most commonly arise in the petrous apex and middle ear. Congenital cholesteatomas arising...
BACKGROUND
Congenital cholesteatomas account for just up to 5% of all cholesteatomas and most commonly arise in the petrous apex and middle ear. Congenital cholesteatomas arising in the mastoid are rare and typically present late.
METHODS
In this study, we report a case series of 3 cases managed in our department between 2006 and 2021 and present a summary of the current literature.
RESULTS
Congenital cholesteatomas arising in the mastoid is a rare finding and even among reported cases, not all are clearly mastoid in origin. Their location allows for considerable growth before symptoms develop. Pain and localized swelling in the temporal area are the most common presenting symptoms which can lead to diagnostic challenges. Our cases show that although surgery is often appropriate, conservative manage- ment may be suitable in certain situations.
CONCLUSION
Congenital cholesteatoma of mastoid origin is rare and can present a diagnostic challenge. Greater awareness is important to facilitate early detection. A high index of suspicion is needed in those presenting with retro-auricular pain and swelling in the context of a normal ontological examination.
Topics: Bone Diseases; Cholesteatoma; Cholesteatoma, Middle Ear; Ear, Middle; Earache; Humans; Mastoid
PubMed: 35072629
DOI: 10.5152/iao.2022.21450 -
Vestnik Otorinolaringologii 2023Osteomas of the temporal bone are rare, especially osteomas originating from the mastoid process. Most often occur in women aged 20-30 years. The maximum growth rate is...
Osteomas of the temporal bone are rare, especially osteomas originating from the mastoid process. Most often occur in women aged 20-30 years. The maximum growth rate is observed during puberty. Usually, the neoplasm becomes an accidental finding on X-rays or CT scans. The clinic of osteoma depends on its location and size. The patient may complain of a cosmetic defect, headache, discomfort and a feeling of heaviness in the area of the neoplasm. In this clinical case, a long-term asymptomatic course of osteoma of the temporal bone is described. CT examination was used for its visualization, and treatment was carried out surgically using a drill.
Topics: Humans; Female; Mastoid; Temporal Bone; Osteoma; Tomography, X-Ray Computed
PubMed: 38153900
DOI: 10.17116/otorino20238806197 -
The American Journal of Medicine Mar 2021Asymptomatic mastoid effusions have recently been observed in astronauts returning from long-term spaceflight. In hospitalized patients, mastoid effusion increases the...
BACKGROUND
Asymptomatic mastoid effusions have recently been observed in astronauts returning from long-term spaceflight. In hospitalized patients, mastoid effusion increases the risks for bacterial otitis and mastoiditis. We reasoned that cephalad fluid shifts during strict -6° head down tilt bed rest could reproduce space-flight associated mastoid effusion and that artificial gravity may reverse the response.
METHODS
The recent Artificial Gravity Bed Rest Study-European Space Agency study (AGBRESA) tested influences of artificial gravity during 60 days head down bed rest on a short-arm human centrifuge in healthy participants. The two intervention groups received daily artificial gravity with 30 minutes continuous artificial gravity or intermittent artificial gravity. A third group served as a control group and received no artificial gravity. We assessed cranial magnetic resonance images for mastoid effusions 1 day before bed rest, at days 14 and 52 of bed rest, and 3 days after bed rest.
RESULTS
None of the participants exhibited mastoid effusions before bed rest. Six participants showed mastoid effusions at bed rest day 14 (4 continuous, 2 intermittent, 0 control). Fifteen participants showed mastoid effusions at bed rest day 52 and 3 days after bed rest (7 continuous, 3 intermittent, 5 control).
CONCLUSIONS
Mastoid effusions commonly occur during strict head down tilt bed rest. The model can be applied to study the mechanisms and potential countermeasures for space flight-associated mastoid effusions. Formation of mastoid effusions during head down tilt bed rest is not prevented by daily 30 minutes short-arm intermittent or continuous centrifugation.
Topics: Adult; Bed Rest; Body Fluids; Female; Gravity, Altered; Head-Down Tilt; Humans; Male; Mastoid
PubMed: 33115615
DOI: 10.1016/j.amjmed.2020.09.020 -
Radiographics : a Review Publication of... 2021The anatomy of the temporal bone is complex, and postoperative imaging evaluation of this bone can be challenging. Surgical approaches to the temporal bone can be... (Review)
Review
The anatomy of the temporal bone is complex, and postoperative imaging evaluation of this bone can be challenging. Surgical approaches to the temporal bone can be categorized didactically into tympanoplasty and ossicular reconstruction, mastoidectomy, and approaches to the cerebellopontine angle and internal auditory canal (IAC). In clinical practice, different approaches can be combined for greater surgical exposure. Postoperative imaging may be required for follow-up of neoplastic lesions and to evaluate unexpected outcomes or complications of surgery. CT is the preferred modality for assessing the continuity of the reconstructed conductive mechanism, from the tympanic membrane to the oval window, with use of grafts or prostheses. It is also used to evaluate aeration of the tympanic and mastoid surgical cavities, as well as the integrity of the labyrinth, ossicular chain, and tegmen. MRI is excellent for evaluation of soft tissue. Use of a contrast-enhanced fat-suppressed MRI sequence is optimal for follow-up after IAC procedures. Non-echo-planar diffusion-weighted imaging is optimal for detection of residual or recurrent cholesteatoma. The expected imaging findings and complications of the most commonly performed surgeries involving the temporal bone are summarized in this review. RSNA, 2021.
Topics: Cholesteatoma, Middle Ear; Humans; Mastoid; Retrospective Studies; Temporal Bone; Treatment Outcome
PubMed: 33739892
DOI: 10.1148/rg.2021200126 -
International Journal of Pediatric... Nov 2023To identify and review key research advances from the literature published between 2019 and 2023 on the diagnosis and microbiology of otitis media (OM) including acute... (Review)
Review
OBJECTIVES
To identify and review key research advances from the literature published between 2019 and 2023 on the diagnosis and microbiology of otitis media (OM) including acute otitis media (AOM), recurrent AOM (rAOM), otitis media with effusion (OME), chronic suppurative otitis media (CSOM) and AOM complications (mastoiditis).
DATA SOURCES
PubMed database of the National Library of Medicine.
REVIEW METHODS
All relevant original articles published in Medline in English between July 2019 and February 2023 were identified. Studies that were reviews, case studies, relating to OM complications (other than mastoiditis), and studies focusing on guideline adherence, and consensus statements were excluded. Members of the panel drafted the report based on these search results.
MAIN FINDINGS
For the diagnosis section, 2294 unique records screened, 55 were eligible for inclusion. For the microbiology section 705 unique records were screened and 137 articles were eligible for inclusion. The main themes that arose in OM diagnosis were the need to incorporate multiple modalities including video-otoscopy, tympanometry, telemedicine and artificial intelligence for accurate diagnoses in all diagnostic settings. Further to this, was the use of new, cheap, readily available tools which may improve access in rural and lowmiddle income (LMIC) settings. For OM aetiology, PCR remains the most sensitive method for detecting middle ear pathogens with microbiome analysis still largely restricted to research use. The global pandemic response reduced rates of OM in children, but post-pandemic shifts should be monitored.
IMPLICATION FOR PRACTICE AND FUTURE RESEARCH
Cheap, easy to use multi-technique assessments combined with artificial intelligence and/or telemedicine should be integrated into future practice to improve diagnosis and treatment pathways in OM diagnosis. Longitudinal studies investigating the in-vivo process of OM development, timings and in-depth interactions between the triad of bacteria, viruses and the host immune response are still required. Standardized methods of collection and analysis for microbiome studies to enable inter-study comparisons are required. There is a need to target underlying biofilms if going to effectively prevent rAOM and OME and possibly enhance ventilation tube retention.
Topics: Child; Humans; Mastoiditis; Artificial Intelligence; Otitis Media; Otitis Media with Effusion; Ear, Middle
PubMed: 37788516
DOI: 10.1016/j.ijporl.2023.111741 -
The Journal of International Advanced... Dec 2020A case of mastoid dermoid cyst (DC) was presented, and differences with cases of other temporal bone DCs were analyzed. The mastoid DC was also compared with mastoid... (Review)
Review
A case of mastoid dermoid cyst (DC) was presented, and differences with cases of other temporal bone DCs were analyzed. The mastoid DC was also compared with mastoid congenital cholesteatoma. We reported a case of a patient with mastoid DC, evaluating her clinical, radiological, and surgical findings. A review of the literature was performed to compare our findings with those reported. The preoperative radiological evaluation prompted us to plan a surgical approach to the lesion, suspecting the presence of a mastoid congenital cholesteatoma. The surgical findings were in line with the presence of a mastoid DC. Only two cases reported in the literature presented features that fulfilled the criteria of a true mastoid DC. A DC confined to the mastoid region is an extremely rare clinical entity, with asymptomatic and slow growth. Preoperative radiological differentiation between congenital cholesteatoma and DCs with atypical features can be difficult. However, surgical excision is the treatment of choice in both cases. Diagnosis is confirmed by the histological evaluation.
Topics: Cholesteatoma, Middle Ear; Dermoid Cyst; Female; Humans; Magnetic Resonance Imaging; Mastoid; Middle Aged
PubMed: 33136032
DOI: 10.5152/iao.2020.7854 -
The Turkish Journal of Pediatrics 2023Acute mastoiditis (AM) is a severe infection of the mastoid air cells that occurs in cases of acute, sub-acute, or chronic middle ear infections. No definitive consensus... (Review)
Review
BACKGROUND
Acute mastoiditis (AM) is a severe infection of the mastoid air cells that occurs in cases of acute, sub-acute, or chronic middle ear infections. No definitive consensus regarding the management of AM has been identified. The current guidelines include a conservative approach (parenteral antibiotics alone, antibiotics plus minor surgical procedures such as myringotomy with a ventilation tube inserted or drainage of the subperiosteal abscess through retro-auricolar incision or needle aspiration) or surgical treatment (mastoidectomy). The main aim of this review was to evaluate and summarize the current knowledge about the management of pediatric AM by analyzing the current evidence in the literature.
METHODS
We examined the following bibliographic electronic databases: Pubmed and the Cochrane Library, from the inception date until February 2023. The search was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISM). The key words used for the search across electronic databases were: `mastoiditis` and `management`; `mastoiditis` and `surgery`; `mastoiditis` and `conservative`; `mastoiditis` and `antibiotics`; `mastoiditis` and `myringotomy`; `mastoiditis` and `grommet`; `mastoiditis` and `drainage`; and `mastoiditis` and `mastoidectomy`.
RESULTS
We selected 12 articles involving 1124 episodes of mastoiditis. Some of these studies considered medical therapy alone as a valid first step, whereas others considered a minor surgical intervention as an initial approach along with antibiotic therapy. Considering the studies that evaluated medical therapy as the initial sole treatment option, the success rate of antibiotics alone was 24.6%. Overall, the success rate of minor surgical procedures, excluding mastoidectomy, was 87.7%, whereas the mastoidectomy success rate was 97%.
CONCLUSIONS
Overall, there is no shared consensus on the diagnostic or therapeutic approach to mastoiditis. Conservative therapy has gained considerable ground in recent times, quite limiting the predominant role of mastoidectomy. Further studies will be necessary to definitely develop standardized protocols shared in the scientific community.
Topics: Humans; Child; Mastoiditis; Abscess; Anti-Bacterial Agents; Conservative Treatment
PubMed: 38204305
DOI: 10.24953/turkjped.2023.320 -
Laryngo- Rhino- Otologie Jan 2022
Topics: Anti-Bacterial Agents; Humans; Infant; Mastoiditis; Retrospective Studies
PubMed: 34963148
DOI: 10.1055/a-1274-9416