title: Acute mastoiditis in children: is computed tomography always necessary?
abstract: OBJECTIVE
  Acute mastoiditis (AM) is the most common intratemporal complication of acute otitis media in children. In the past decade, reports have indicated a rise in the incidence of AM in the pediatric population. A parallel rise in the use of computed tomography (CT) imaging has occurred. The rise in the use of CT scanning in the pediatric population, entraining with it a rise in pediatric brain irradiation, has led us to question the necessity of using CT for pediatric patients with AM.
  
  
  METHODS
  We reviewed the medical files of pediatric patients who had AM in the years 2005 through 2007.
  
  
  RESULTS
  Fifty patients were identified. The gender distribution was equal, and the ages ranged from 4 months to 12 years. Of the 46 patients who were admitted to our institution "de novo," only 2 underwent CT scanning on admission, and 4 other patients had CT performed during hospitalization. The majority of patients (92%) with AM did not have a CT scan performed and were treated conservatively with no complications.
  
  
  CONCLUSIONS
  In most pediatric patients, CT does not seem to be indispensable in the diagnosis of AM. Conservative therapy and close follow-up seem to suffice for most.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tamir
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Schwartz
authors.forename: Uri
authors.initials: U
authors.lastname: Peleg
authors.forename: Ronen
authors.initials: R
authors.lastname: Perez
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Sichel
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D020380:Needs Assessment; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*