-
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... Dec 2016To evaluate and compare clinical and microbiological findings in adults hospitalized for acute otitis media (AOM) or mastoid infections (acute or latent).
OBJECTIVE
To evaluate and compare clinical and microbiological findings in adults hospitalized for acute otitis media (AOM) or mastoid infections (acute or latent).
MATERIALS AND METHODS
We retrospectively reviewed the medical records of all adults (≥17 years old) hospitalized (between 2003 and 2012) at a tertiary referral center for acute mastoid infections or AOM not responding to outpatient medical treatment.
RESULTS
Of the 160 patients in the study sample, 19% had an infection caused by S. pyogenes, 14% by S. pneumoniae, and 11% by P. aeruginosa. AOM was the most common infection (38%), whereas 33% had acute mastoiditis (AM), 18% had latent mastoiditis (LM), and 13% AM of a chronically infected ear (AMc). In contrast to the other infections, P. aeruginosa (30%) and S. aureus (25%) were most common in AMc. Otorrhea (83%), tympanic membrane perforation (57%), and hearing problems (83%) were common in S. pyogenes infections. Patients with S. pneumoniae had longer lengths of hospitalization than those with other bacterial infections (7 vs. 4 days). Otorrhea (94%) and retroauricular symptoms were more common in P. aeruginosa infections. Hearing symptoms were common (67%) but fever (32%) and retroauricular symptoms were uncommon in AOM. Fever (44%) and mastoid tenderness (65%) were common in AM. Patients with LM underwent the most mastoidectomies (54%). Prior medical conditions, retroauricular symptoms, otorrhea (90%), and post-infection problems were common in AMc.
CONCLUSION
The bacteriological etiology of hospitalized AOM more closely resembled those of LM and AM than that of AMc. Adults hospitalized for AOM or AM required fewer mastoidectomies than those hospitalized for LM or AMc.
Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Female; Hospitalization; Humans; Male; Mastoiditis; Middle Aged; Otitis Media; Pseudomonas aeruginosa; Retrospective Studies; Streptococcus; Young Adult
PubMed: 27895000
DOI: 10.5152/iao.2016.2620 -
Brazilian Journal of Otorhinolaryngology 2008Acute atypical mastoiditis, with temporal and/or facial edema, is called squamozygomatic mastoiditis. There are only a few reports of this occurrence in the literature,... (Review)
Review
UNLABELLED
Acute atypical mastoiditis, with temporal and/or facial edema, is called squamozygomatic mastoiditis. There are only a few reports of this occurrence in the literature, which occurs because of an inflammatory process spread to the zygommatic apophysis, when mastoid pneumatization reaches the zygoma or the squamous portion of the temporal bone. Diagnosis is made based on clinical history, physical exam and mastoid CT scan. Treatment is carried out with antibiotic therapy and surgery.
AIM
To present a case of squamozygomatic mastoiditis and review the literature.
PATIENTS AND METHODS
Report of a case treated in our hospital during the year of 2003 and literature review through the Internet, we also reviewed otolaryngology books from known authors.
DISCUSSION
Squamozygomatic mastoiditis is an atypical mastoiditis in which the inflammatory process spreads to the zygomatic apophysis. The infection reaches the temporal bone squamous portion and makes a fistula between this portion and the temporal muscle, shifting the pinna of the ear downwards and it may reach the face, eyes and eyelids. Diagnosis is carried out by clinical history, physical examination and mastoid CT Scan. Treatment is surgical, associated with antibiotic therapy.
Topics: Acute Disease; Female; Humans; Mastoiditis; Middle Aged; Pneumococcal Infections; Streptococcus pneumoniae; Treatment Outcome
PubMed: 18852992
DOI: 10.1016/s1808-8694(15)30613-3 -
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 -
Duodecim; Laaketieteellinen... 2014Acute mastoiditis in children develops when acute otitis media (AOM) spreads into the mastoid air cells inside the temporal bone. The diagnosis is based on clinical... (Review)
Review
Acute mastoiditis in children develops when acute otitis media (AOM) spreads into the mastoid air cells inside the temporal bone. The diagnosis is based on clinical findings of AOM with simultaneous signs of infection in the mastoid area. The most common pathogen causing acute mastoiditis in children is Streptococcus pneumoniae. Intravenous antimicrobial medication, tympanostomy and microbial sample are the cornerstones of the treatment. If a complication of mastoiditis is suspected, imaging studies are needed, preferably with magnetic resonance imaging. The most common complication of acute mastoiditis is a subperiosteal abscess.
Topics: Acute Disease; Anti-Bacterial Agents; Child; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Mastoiditis; Middle Ear Ventilation
PubMed: 24660384
DOI: No ID Found -
Clinical Radiology Apr 2013Acute mastoiditis is a commonly occurring condition in children and adults, and one that most radiologists will come across at some point during their on-call duties.... (Review)
Review
Acute mastoiditis is a commonly occurring condition in children and adults, and one that most radiologists will come across at some point during their on-call duties. Acute mastoiditis is usually clinically apparent. However, the complications, especially the intracranial ones, can be more insidious and may have fatal consequences. Therefore, it is imperative that the radiologist is well versed in identifying these. Local spread of infection from the mastoids and middle ear cleft may occur via four routes: bone erosion, thrombophlebitis, periphlebitis, and via the anatomical pathways. The role of radiology is largely to demonstrate the complications of mastoiditis, which can be clinically occult and are often serious; this article will highlight these complications.
Topics: Acute Disease; Adult; Child; Contrast Media; Humans; Magnetic Resonance Imaging; Mastoid; Mastoiditis; Radiographic Image Enhancement; Tomography, X-Ray Computed
PubMed: 22980753
DOI: 10.1016/j.crad.2012.07.019 -
Pediatric Annals May 2016Acute mastoiditis (AM) is a relatively rare complication of acute otitis media (AOM). The most common pathogens include Streptococcus pneumoniae, Streptococcus pyogenes,... (Review)
Review
Acute mastoiditis (AM) is a relatively rare complication of acute otitis media (AOM). The most common pathogens include Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus. Pneumococcal vaccination and changes in antibiotic prescribing recommendations for AOM may change the incidence of AM in the future. Diagnosis of AM can be made based on clinical presentation, but computed tomography of the temporal bone with contrast should be considered if there is concern for complicated AM. Both extracranial and intracranial complications of AM may occur. Previously, routine cortical mastoidectomy was recommended for AM treatment, but new data suggest that a more conservative treatment approach can be considered, including intravenous (IV) antibiotics alone or IV antibiotics with myringotomy. [Pediatr Ann. 2016;45(5):e176-e179.].
Topics: Abscess; Acute Disease; Anti-Bacterial Agents; Ceftriaxone; Female; Humans; Infant; Mastoid; Mastoiditis; Otitis Media with Effusion; Periosteum; Periostitis; Pneumococcal Infections; Streptococcus pneumoniae; Tomography, X-Ray Computed
PubMed: 27171806
DOI: 10.3928/00904481-20160328-01 -
HNO Jan 2007Acute mastoiditis is an acute inflammation of the mastoid process with bone erosion. It is a complication of acute otitis media, which is rare but with increasing... (Review)
Review
Acute mastoiditis is an acute inflammation of the mastoid process with bone erosion. It is a complication of acute otitis media, which is rare but with increasing incidence. Distinct characteristics are an erythema and oedematous swelling of the skin of the mastoid process. A fluctuant swelling points to a subperiosteal abscess. Laboratory examination and imaging only support the diagnostics. Therapy involves obligatory systemic antibiotic treatment. At the beginning of the inflammation a paracentesis can be sufficient. A mastoidectomy must be carried out if clear signs of an osseous necrolysis, such as a subperiosteal abscess, are present. The most frequent causative agents are gram positive cocci. Intraoperative smears are best suitable for microbiological diagnostics. Complications of acute mastoiditis are encroachments of the inflammation on neighbouring structures of the mastoid. In such cases a tomography is indicated and therapy is usually surgical.
Topics: Acute Disease; Anti-Bacterial Agents; Gram-Positive Bacterial Infections; Humans; Mastoid; Mastoiditis; Otologic Surgical Procedures; Practice Guidelines as Topic; Practice Patterns, Physicians'
PubMed: 17149635
DOI: 10.1007/s00106-006-1468-6 -
American Family Physician Jun 1987Mastoiditis still occurs as a nonmeningeal complication of otitis media. Fever, postauricular swelling, tenderness of the ear pinna, severe otalgia and ear drainage are...
Mastoiditis still occurs as a nonmeningeal complication of otitis media. Fever, postauricular swelling, tenderness of the ear pinna, severe otalgia and ear drainage are all typical clinical findings. Most commonly, the causative organisms are the same aerobic bacteria that are responsible for otitis media; however, anaerobic organisms must also be considered. Treatment for acute mastoiditis includes appropriate intravenous antibiotics and myringotomy for culture and drainage. Mastoidectomy is indicated if medical therapy fails.
Topics: Adolescent; Bacteria, Aerobic; Bacteria, Anaerobic; Humans; Male; Mastoiditis; Otitis Media
PubMed: 3504099
DOI: No ID Found -
The American Journal of Emergency... May 2024Acute mastoiditis is a serious condition that carries with it a high rate of morbidity and mortality. (Review)
Review
INTRODUCTION
Acute mastoiditis is a serious condition that carries with it a high rate of morbidity and mortality.
OBJECTIVE
This review highlights the pearls and pitfalls of mastoiditis, including the presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
DISCUSSION
Acute mastoiditis most commonly affects pediatric patients and is a suppurative infection of the mastoid air cells. It is often associated with otitis media, and common bacteria include Streptococcus and Staphylococcus. History and examination may reveal tympanic membrane erythema, pinna protrusion, postauricular erythema, mastoid tenderness with palpation, external canal swelling, otorrhea, fever, and malaise. The disease should be suspected in those who fail treatment for otitis media and those who demonstrate the aforementioned abnormalities on examination and systemic symptoms. Laboratory analysis may reveal evidence of systemic inflammation, but a normal white blood cell count and other inflammatory markers should not be used to exclude the diagnosis. Computed tomography (CT) of the temporal bones with intravenous contrast is the recommended imaging modality if the clinician is unsure of the diagnosis. CT may also demonstrate complications. Treatment includes antibiotics such as ampicillin-sulbactam or ceftriaxone as well as otolaryngology consultation. Complications may include subperiosteal and intracranial abscess, deep neck abscess, facial nerve palsy, meningitis/encephalitis, venous sinus thrombosis, and seizures.
CONCLUSIONS
An understanding of acute mastoiditis can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
Topics: Humans; Child; Mastoiditis; Abscess; Prevalence; Otitis Media; Acute Disease; Erythema
PubMed: 38368849
DOI: 10.1016/j.ajem.2024.02.009