title: Acute mastoidectomy in a Danish county from 1977 to 1997--operative findings and long-term results.
abstract: Data from patients undergoing acute mastoidectomy were examined retrospectively to evaluate if the nature of acute mastoiditis (AM) treated surgically has changed during the last 20 years (1977-97). Moreover, a prevalence study was conducted to clarify the otological and audiological course following acute mastoidectomy. Patients with cholesteatoma and intracranial complications were excluded. Thus, 79 patients with a median age of 16 months were included. Thirty-seven percent had a history of middle ear disease, and the mean duration from onset of symptoms to admission was 9 days. Well-being was affected in 46%, and 82% had fever. The clinical picture was dominated by auricular protrusion (77%) and pathological tympanic membrane (94%). Postauricular oedema, hyperaemia and tenderness were demonstrated in 89%, 78% and 49% of cases, respectively. Peroperatively, purulent middle ear effusion was recognized in 92%, subperiosteal abscess in 66% and pus in the mastoid in 90%. Specimens revealed growth of pathogens in 58%, predominantly Gram-positive bacteria. The observation period was 1-20 years. The findings in operated ears were not significantly different from the contralateral non-operated ears concerning incidence of otitis media, hearing and ear canal volume. Conclusively, acute mastoidectomy is a safe and effective treatment to eliminate infection. The operation can be done with negligible risk and does not leave long-term sequelae.
authors.affiliation: Ear, Nose and Throat Department, Aarhus University Hospital, Denmark.
authors.forename: C G
authors.initials: CG
authors.lastname: Petersen
authors.forename: T
authors.initials: T
authors.lastname: Ovesen
authors.forename: C B
authors.initials: CB
authors.lastname: Pedersen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000382:microbiology; D013506:Otologic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000382:microbiology