Acute mastoiditis in children: is computed tomography always necessary?
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.
Tamir
Sharon
S
Department of Otolaryngology-Head and Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Schwartz
Yehuda
Y
Peleg
Uri
U
Perez
Ronen
R
Sichel
Jean-Yves
JY
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*