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PloS One 2015To report the incidence of and risk factors for mastoiditis after intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC).
PURPOSE
To report the incidence of and risk factors for mastoiditis after intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC).
PATIENTS AND METHODS
Retrospective analysis of pretreatment and follow-up magnetic resonance imaging (MRI) data for 451 patients with NPC treated with IMRT at a single institution. The diagnosis of mastoiditis was based on MRI; otomastoid opacification was rated as Grade 0 (none), 1 (mild), 2 (moderate) or 3 (severe) by radiologists blinded to clinical outcome. This study mainly focused on severe mastoiditis; patients were divided into three groups: the G0M (Grade 0 mastoiditis before treatment) group, G1-2M (Grade 1 to 2 mastoiditis before treatment) group and G3M (Grade 3 mastoiditis before treatment) group. The software SAS9.3 program was used to analyze the data.
RESULTS
For the entire cohort, the incidence of Grade 3 mastoiditis was 20% before treatment and 31%, 19% and 17% at 3, 12 and 24 months after radiotherapy, respectively. In the G0M group, the incidence of severe mastoiditis was 0% before treatment and 23%, 15% and 13% at 3, 12 and 24 months after radiotherapy, respectively. Multivariate analysis revealed T category (OR=0.68, 95% CI = 0.469 to 0.984), time (OR=0.668, 95% CI = 0.59 to 0.757) and chemotherapy (OR=0.598, 95% CI = 0.343 to 0.934) were independent factors associated with severe mastoiditis in the G0M group after treatment.
CONCLUSIONS
Mastoiditis, as diagnosed by MRI, occurs as a progressive process that regresses and resolves over time in patients with NPC treated using IMRT.
Topics: Aged; Carcinoma; Female; Humans; Incidence; Male; Mastoiditis; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Radiation Injuries; Radiotherapy, Intensity-Modulated; Risk Factors
PubMed: 26114761
DOI: 10.1371/journal.pone.0131284 -
European Archives of... May 2024To describe characteristics of pediatric patients with recurrent acute mastoiditis, and to identify risk factors for this condition.
OBJECTIVE
To describe characteristics of pediatric patients with recurrent acute mastoiditis, and to identify risk factors for this condition.
STUDY DESIGN
A retrospective cohort study.
SETTING
Data based on electronic medical records of the largest Health Maintenance Organization in Israel.
METHODS
Children hospitalized due to acute mastoiditis during the years 2008-2018 were identified, and their diagnosis was verified. Patients with recurrent acute mastoiditis were identified and grouped, and their characteristics were outlined and compared to those of the original group to identify risk factors for recurrence.
RESULTS
During the 11-year period, a total of 1115 cases of children hospitalized due to acute mastoiditis were identified with a weighted incidence rate of 7.8/100,000. Of this group, 57 patients were diagnosed with recurrence following a full clinical recovery. The incidence proportion of recurrent acute mastoiditis was 5.1% (57/1115), male-to-female ratio was 27:30, 73.4% were younger than 24 months, the median period from the first episode was 3.4 months (IQR 2.0;10.0), and 82.5% of the patients (n = 47) had a single recurrence, whereas 18.5% (n = 10) had two recurrences or more. Mastoidectomy and swelling over the mastoid area during the first episode were identified as the main risk factors for recurrent mastoiditis HR = 4.7 [(2.7-8.2), p < 0.001] and HR = 2.55 [(1.4-4.8), p = 0.003], respectively. Mastoidectomy was the only independent significant risk factor for recurrence in a multivariate analysis.
CONCLUSIONS
Mastoidectomy and swelling over the mastoid area during the first episode of acute mastoiditis were found strongly related independent risk factor for future recurrent episodes of acute mastoiditis.
Topics: Child; Humans; Male; Female; Infant; Mastoiditis; Cohort Studies; Retrospective Studies; Mastoid; Risk Factors; Registries; Acute Disease; Anti-Bacterial Agents
PubMed: 38342819
DOI: 10.1007/s00405-024-08473-8 -
Scientific Reports Jul 2023The aim of this study was to understand the mastoid volume development in children who undergo cochlear implantation surgery. Cochlear implant (CI) database of our...
The aim of this study was to understand the mastoid volume development in children who undergo cochlear implantation surgery. Cochlear implant (CI) database of our clinic (Kuopio University Hospital) was reviewed for computed tomography (CT) images of CI patients (age under 12 years at the time of implantation) with a minimum time interval of twelve months between their pre- and postoperative CT. Eight patients (nine ears) were found eligible for inclusion. Three linear measurements were taken by using picture archiving and communication systems (PACS) software and the volume of the MACS was measured with Seg 3D software. The mastoid volume increased on average 817.5 mm between the pre- and the postoperative imaging time point. The linear distances measured between anatomical points like the round window (RW)- bony ear canal (BEC), the RW-sigmoid sinus (SS), the BEC-SS, and the mastoid tip (MT)-superior semicircular canal (SSC) increased significantly with the age of the patient at both the pre-op and post-op time points. The linear measurements between key anatomical points and mastoid volume showed a positive linear correlation. The correlation between linear measurement and volume were significant between the MT-SSC (r = 0.706, p = 0.002), RW-SS (r = 0.646, p = 0.005) and RW-BEC (r = 0.646, p = 0.005). Based on our findings from the CI implanted patients and comparing it with the previous literature findings from non-CI implanted patients, we could say that the CI surgery seem to have no effect on the development of mastoid volume in children.
Topics: Humans; Child; Cochlear Implantation; Mastoid; Cochlear Implants; Round Window, Ear; Ear
PubMed: 37414822
DOI: 10.1038/s41598-023-37160-7 -
Italian Journal of Pediatrics Jun 2018Acute mastoiditis is the main suppurative complication of acute otitis media. Its incidence ranges from 1.2 to 4.2/100.000 children/year and a rise has been reported in...
BACKGROUND
Acute mastoiditis is the main suppurative complication of acute otitis media. Its incidence ranges from 1.2 to 4.2/100.000 children/year and a rise has been reported in the last years. There are controversial data regarding risk factors for mastoiditis and its complications.
AIM OF THE STUDY
to evaluate demographics and clinical characteristics of children with acute mastoiditis and to identify possible risk factors for complications.
METHODS
We retrospectively reviewed medical charts of all the children aged 1 month-14 years admitted to our Paediatric Emergency Department from January 2002 to December 2016.
RESULTS
One hundred forty-seven cases (97 males and 50 females) were included in the analysis, mean age was 4.8 ± 3.6 years and 28.2% of the patients were younger than 2 years. We found an increasing number of mastoiditis per year during the last 3 years of the study. Children younger than 2 years were less treated with antibiotics for acute otitis media or treated for a shorter period (p < 0.05), while they were treated at higher antibiotic's dosage for mastoiditis (p < 0.01). Older children presented more frequently with symptoms such as earache or retroauricular pain (p < 0.0001, p < 0.001). We didn't identify any risk factor for mastoiditis complications in our study.
CONCLUSIONS
Despite the introduction of pneumococcal vaccines, the incidence of acute mastoiditis in our population has not been reduced during the last years. We have to face all the reasons why this condition is still relevant, such as antibiotic resistance, new pathogens involved and a possible role played by the implementations of therapeutic acute otitis media guidelines restricting the use of antibiotics in this disease. A particular attention should be given to younger children where signs and symptoms may be less pronounced, therefore acute otitis media or mastoiditis may be misunderstood and appropriate treatment delayed.
Topics: Acute Disease; Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Forecasting; Humans; Incidence; Infant; Infant, Newborn; Italy; Male; Mastoiditis; Otitis Media; Retrospective Studies; Risk Factors
PubMed: 29914542
DOI: 10.1186/s13052-018-0511-z -
Bosnian Journal of Basic Medical... May 2007The objective was to review our experience with clinical course, diagnostic and therapeutic profile of children treated for acute mastoiditis, and to investigate for...
The objective was to review our experience with clinical course, diagnostic and therapeutic profile of children treated for acute mastoiditis, and to investigate for possible susceptibility factors. Study was designed as retrospective review of pediatric patients presenting with acute mastoiditis secondary to acute otitis media over the last 6 years, from 2000 to 2006. The study involved children aged from 1 to 16 years treated for acute mastoiditis and subsequent intratemporal and intracranial complications in Clinic for otorhinolaryngology, Clinic Center Banja Luka. Selected clinical parameters, mastoid coalescence and risk factors for necessity of surgical intervention were analyzed. Medical history review of a total of 13 patients with acute mastoiditis was analyzed. Acute coalescent mastoiditis occurred 11 patients (84%) while noncoalescent form of acute mastoiditis occurred in 2 cases (16%). Intracranial complication occurred in 3 patients (2 meningitis and 1 peridural intracranial abscess), while 2 patients had intratemporal complication (subperiostal abscess) associated to coalescent mastoiditis. We observed clinical profile of acute mastoiditis in regard to pathology found on the tympanic membrane, middle ear mucosa and destructions on the bony wall of the middle ear and mastoid. The main signs of progressive infection were tympanic membrane perforation, pulsatile suppurative secretion from the mucosa, and intratemporal abscess. All patients with coalescent mastoiditis required mastoidectomy, while noncoalescent mastoiditis was treated conservatively with broad-spectrum intravenous antibiotics and myringotomy. In conclusion acute mastoiditis is uncommon but serious complication of acute otitis media in children associated with significant morbidity. Coalescent mastoiditis concomitant with subperiostal abscess, intracranial complications and mastoiditis not responsive after 48 hours to intravenous antibiotics should urge clinician to timely mastoid surgery.
Topics: Acute Disease; Adolescent; Anti-Bacterial Agents; Bosnia and Herzegovina; Child; Child, Preschool; Disease Susceptibility; Ear, Middle; Humans; Infant; Magnetic Resonance Imaging; Mastoid; Mastoiditis; Otitis Media; Retrospective Studies; Treatment Outcome; Tympanic Membrane
PubMed: 17489747
DOI: 10.17305/bjbms.2007.3066 -
The Journal of International Advanced... Jan 2023Langerhans cell histiocytosis is a rare condition affecting the temporal bone in up to 60% of cases. Symptoms are non-specific and the differential diagnosis includes...
Langerhans cell histiocytosis is a rare condition affecting the temporal bone in up to 60% of cases. Symptoms are non-specific and the differential diagnosis includes infection, benign lesions such as cholesteatoma, and malignant lesions of the skull base. Here, we report the case of a 14-yearold child referred with chronic ear discharge, and background of multifocal Langerhans cell histiocytosis 9 years prior. Recurrence of Langerhans cell histiocytosis was initially suspected and systemic treatment was considered. Further imaging workup and surgical exploration of the mastoid showed a secondary acquired cholesteatoma arising from a dehiscent posterior ear canal wall. Surgical removal of the cholesteatoma was performed with a canal wall down procedure. We review the presentation and management of temporal bone Langerhans cell histiocytosis. We recommend that cholesteatoma should be considered in case of recurrence of otological symptoms in patients with a background of Langerhans cell histiocytosis.
Topics: Adolescent; Humans; Cholesteatoma; Cholesteatoma, Middle Ear; Ear Canal; Ear Diseases; Histiocytosis, Langerhans-Cell; Mastoid; Recurrence; Retrospective Studies; Temporal Bone
PubMed: 36718041
DOI: 10.5152/iao.2023.22716 -
Italian Journal of Pediatrics Sep 2020Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due... (Review)
Review
BACKGROUND
Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011.
CASE PRESENTATION
The child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient's full recovery.
CONCLUSION
Cerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.
Topics: Humans; Infant; Male; Mastoiditis; Otitis Media; Sinus Thrombosis, Intracranial
PubMed: 32883359
DOI: 10.1186/s13052-020-00882-9 -
Journal of Biomedical Optics Jun 2023Cholesteatoma is an expansile destructive lesion of the middle ear and mastoid, which can result in significant complications by eroding adjacent bony structures....
SIGNIFICANCE
Cholesteatoma is an expansile destructive lesion of the middle ear and mastoid, which can result in significant complications by eroding adjacent bony structures. Currently, there is an inability to accurately distinguish cholesteatoma tissue margins from middle ear mucosa tissue, causing a high recidivism rate. Accurately differentiating cholesteatoma and mucosa will enable a more complete removal of the tissue.
AIM
Develop an imaging system to enhance the visibility of cholesteatoma tissue and margins during surgery.
APPROACH
Cholesteatoma and mucosa tissue samples were excised from the inner ear of patients and illuminated with 405, 450, and 520 nm narrowband lights. Measurements were made with a spectroradiometer equipped with a series of different longpass filters. Images were obtained using a red-green-blue (RGB) digital camera equipped with a long pass filter to block reflected light.
RESULTS
Cholesteatoma tissue fluoresced under 405 and 450 nm illumination. Middle ear mucosa tissue did not fluoresce under the same illumination and measurement conditions. All measurements were negligible under 520 nm illumination conditions. All spectroradiometric measurements of cholesteatoma tissue fluorescence can be predicted by a linear combination of emissions from keratin and flavin adenine dinucleotide. We built a prototype of a fluorescence imaging system using a 495 nm longpass filter in combination with an RGB camera. The system was used to capture calibrated digital camera images of cholesteatoma and mucosa tissue samples. The results confirm that cholesteatoma emits light when it is illuminated with 405 and 450 nm, whereas mucosa tissue does not.
CONCLUSIONS
We prototyped an imaging system that is capable of measuring cholesteatoma tissue autofluorescence.
Topics: Humans; Cholesteatoma, Middle Ear; Ear, Middle; Mucous Membrane; Mastoid; Optical Imaging
PubMed: 37334207
DOI: 10.1117/1.JBO.28.6.066003 -
PloS One 2020This study aimed to compare the diagnostic performance of deep learning algorithm trained by single view (anterior-posterior (AP) or lateral view) with that trained by...
OBJECTIVES
This study aimed to compare the diagnostic performance of deep learning algorithm trained by single view (anterior-posterior (AP) or lateral view) with that trained by multiple views (both views together) in diagnosis of mastoiditis on mastoid series and compare the diagnostic performance between the algorithm and radiologists.
METHODS
Total 9,988 mastoid series (AP and lateral views) were classified as normal or abnormal (mastoiditis) based on radiographic findings. Among them 792 image sets with temporal bone CT were classified as the gold standard test set and remaining sets were randomly divided into training (n = 8,276) and validation (n = 920) sets by 9:1 for developing a deep learning algorithm. Temporal (n = 294) and geographic (n = 308) external test sets were also collected. Diagnostic performance of deep learning algorithm trained by single view was compared with that trained by multiple views. Diagnostic performance of the algorithm and two radiologists was assessed. Inter-observer agreement between the algorithm and radiologists and between two radiologists was calculated.
RESULTS
Area under the receiver operating characteristic curves of algorithm using multiple views (0.971, 0.978, and 0.965 for gold standard, temporal, and geographic external test sets, respectively) showed higher values than those using single view (0.964/0.953, 0.952/0.961, and 0.961/0.942 for AP view/lateral view of gold standard, temporal external, and geographic external test sets, respectively) in all test sets. The algorithm showed statistically significant higher specificity compared with radiologists (p = 0.018 and 0.012). There was substantial agreement between the algorithm and two radiologists and between two radiologists (κ = 0.79, 0.8, and 0.76).
CONCLUSION
The deep learning algorithm trained by multiple views showed better performance than that trained by single view. The diagnostic performance of the algorithm for detecting mastoiditis on mastoid series was similar to or higher than that of radiologists.
Topics: Algorithms; Deep Learning; Humans; Mastoid; Mastoiditis; ROC Curve; Retrospective Studies
PubMed: 33176335
DOI: 10.1371/journal.pone.0241796 -
The Tokai Journal of Experimental and... Jul 2023Bezold's abscess is an extracranial complication of otitis media, in which a cervical abscess forms from the mastoid process through an ostial fistula, and is a rare...
Bezold's abscess is an extracranial complication of otitis media, in which a cervical abscess forms from the mastoid process through an ostial fistula, and is a rare condition in recent years. In this study, we experienced a X-linked agammaglobulinemia, which was discovered due to Bezold's abscess. Case: A 12-year-old boy suffering from recurrent right suppurative otitis media for three months was treated with tympanostomy and oral antibacterial therapy at a local otorhinolaryngology clinic. The patient visited the clinic due to a recurrence of symptoms. CT showed bony defects in the cortical bone and mastoid process of the lateral side of the right mastoid cell. The patient was referred to our hospital, admitted the same day and underwent emergency surgery. Intraoperative findings led to the diagnosis of acute mastoiditis and Bezold's abscess c aused b y mastoiditis spreading to the s ternocleidomastoid muscle. After drainage and administration of ABPC/SBT, the abscess disappeared, and the patient's general condition improved. Subsequently, a blood typing test performed on admission suggested the influence of low immunoglobulin levels. A close examination by the pediatric department led to a diagnosis of X-linked agammaglobulinemia. As a result, the patient receives regular immunoglobulin therapy and has been free of infection, including Bezold's abscess. CONCLUSIONS: In the case of recurrent otitis media and rare infections, congenital immune abnormalities should be considered.
Topics: Male; Child; Humans; Mastoiditis; Abscess; Otitis Media; Agammaglobulinemia
PubMed: 37356973
DOI: No ID Found