Postauricular needle aspiration of subperiosteal abscess in acute mastoiditis.
To test the hypothesis that subperiosteal abscess, a complication of acute mastoiditis, can be treated equally well by needle aspiration as by cortical mastoidectomy, we performed a retrospective analysis of 78 pediatric patients hospitalized between 1995 and 2003 and performed an analysis of published data on types and outcomes of treatment approaches for acute mastoiditis. Postauricular pus aspiration resolved the subperiosteal abscess in 14 of 17 patients. The length of the hospital stay of patients who underwent aspiration was shorter than that of patients who underwent cortical mastoidectomy. We conclude that postauricular pus aspiration, a simple and minimally invasive procedure, is an effective treatment modality for subperiosteal abscess. Mastoidectomy should be reserved for nonresponsive cases or those with more serious complications. Broad-spectrum antibiotics, myringotomy with daily toilet of the ear, and postauricular aspiration, when required, minimize the indications for surgery and reduce the hospital stay.
Lahav
Jonathan
J
Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, PO Box 1, Rehovot, Israel. yonatan_L@clalit.org.il
Handzel
Ophir
O
Gertler
Reuven
R
Yehuda
Moshe
M
Halperin
Doron
D
D000038:Abscess / Q000628:therapy*; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008416:Mastoid / Q000601:surgery; D008417:Mastoiditis / Q000628:therapy*; D010521:Periosteum / Q000382:microbiology*; D012008:Recurrence; D012189:Retrospective Studies; D013396:Suction; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents