Mastoid subperiosteal abscess: a review of 51 cases.
OBJECTIVE
To present a large study on subperiosteal abscess (SA) that represents the most frequent complication of acute mastoiditis.


METHODS
A retrospective study was conducted on 49 patients who underwent mastoidectomy for SA.


RESULTS
The patients ranged in age from 8 months to 21 years. Two patients were re operated on the same side due to recurrent abscess. Forty-five percent of the patients were treated using antibiotics at home and 58.8% of patients had no history of middle ear infection prior to admission. CT underestimated abscess in two patients who were operated on based on their clinical signs. Perisinus abscess was drained during mastoidectomy in one child. Purulent discharge was obtained from the abscess in 41 cases. The most common isolated pathogens were Streptococcus pyogenes and Staphylococcus aureus. Cholesteatoma was found during mastoidectomy in six patients (11.3%). Twenty-four patients (49%) developed postoperative sequela including various middle ear infections, mastoiditis, recurrent SA and impaired hearing.


CONCLUSIONS
Mastoid SA is a unilateral mainly children's disease that can recur. Cholesteatoma can associate the abscess and could be found in older children and recurrent abscess. High morbidity rate requires long-term follow-up for these patients.
Migirov
Lela
L
Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, 52621 Tel Hashomer, Israel. smigirov@leumit.co.il
Yakirevitch
Arkadi
A
Kronenberg
Jona
J
D000038:Abscess / Q000382:microbiology* / Q000628:therapy*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002558:Cerebrospinal Fluid Otorrhea / Q000382:microbiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear / Q000209:etiology; D005260:Female; D006312:Hearing Loss, Bilateral / Q000209:etiology; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000382:microbiology* / Q000628:therapy*; D010033:Otitis Media / Q000209:etiology; D010521:Periosteum / Q000382:microbiology* / Q000601:surgery*; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents