title: Surgical management of acute mastoiditis with epidural abscess.
abstract: The prevalence of intracranial complications of acute coalescent mastoiditis in children has decreased significantly; however, this clinical problem persists, with a relatively high mortality. The common practice for management of acute mastoiditis with epidural abscess is mastoidectomy, drainage and placement of a ventilation tube, which means that the main pathology is confined to the mastoid cavity. We suggest that tympanic exploration is mandatory in certain cases, an example of which we present here. We report one case of acute mastoiditis with epidural abscess, in which mastoidectomy with tympanic exploration was needed to ensure drainage throughout the cavities and to prevent pressure rebuilding in the mastoid and tympanic cavities. We stress that if the tympanic membrane is thickened and no fluid is drained when placing a pressure equalization tube, there could be granulation tissue in the tympanum and tympanic exploration is mandatory, especially in a case of acute mastoiditis with intracranial complications accompanied by prolonged symptoms.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University School of Medicine, Seoul, Korea. hpark@kuh.ac.kr
authors.forename: Hongju
authors.initials: H
authors.lastname: Park
authors.forename: Hyunjong
authors.initials: H
authors.lastname: Jang
authors.forename: Daebo
authors.initials: D
authors.lastname: Shim
authors.forename: Hyangae
authors.initials: H
authors.lastname: Shin
authors.forename: Jaeyoon
authors.initials: J
authors.lastname: Ahn
authors.forename: Jungeun
authors.initials: J
authors.lastname: Shin
mesh_terms: D000208:Acute Disease; D020802:Epidural Abscess / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D010033:Otitis Media / Q000150:complications; D011008:Pneumococcal Infections / Q000175:diagnosis; D013296:Streptococcus pneumoniae / Q000302:isolation & purification