title: Paediatric acute mastoiditis, then and now: is it more of a problem now?
abstract: BACKGROUND
  Acute mastoiditis is a significant cause of morbidity in the paediatric population. This paper reviews our experience with this condition over the last 10 years and compares it with historical data from Alder Hey Children's Hospital, Liverpool, UK.
  
  
  METHODS
  A retrospective case note review of patients who presented between 2003 and 2012 was performed.
  
  
  RESULTS
  Forty-six patients with acute mastoiditis were identified. Imaging with computed tomography and magnetic resonance imaging was carried out in 14 cases (30.4 per cent). Intracranial complications were identified in six patients (13.0 per cent), one of whom required neurosurgical intervention. In 27 cases (58.7 per cent), a surgical procedure was performed. Data from 1995 to 2000 revealed similar rates of imaging (30.0 per cent), but significantly lower rates of surgical intervention (23 per cent). A lower rate of intracranial complications (4.8 per cent) in the historical cohort did not prove to be statistically significant (p = 0.419).
  
  
  CONCLUSIONS
  The numbers of paediatric patients presenting with acute mastoiditis appears essentially unchanged. Improvement in imaging technology and aids to interpretation may explain the apparent increase of intracranial complications.
authors.affiliation: ENT Department,Aintree University Hospital,Liverpool,UK.
authors.forename: B
authors.initials: B
authors.lastname: Attlmayr
authors.affiliation: Radiology Department,Aintree University Hospital,Liverpool,UK.
authors.forename: S
authors.initials: S
authors.lastname: Zaman
authors.affiliation: ENT Department,Alder Hey Children's NHS Foundation Trust,Liverpool,UK.
authors.forename: J
authors.initials: J
authors.lastname: Scott
authors.affiliation: ENT Department,Aintree University Hospital,Liverpool,UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Derbyshire
authors.affiliation: ENT Department,Alder Hey Children's NHS Foundation Trust,Liverpool,UK.
authors.forename: R W
authors.initials: RW
authors.lastname: Clarke
authors.affiliation: ENT Department,Alder Hey Children's NHS Foundation Trust,Liverpool,UK.
authors.forename: S
authors.initials: S
authors.lastname: De
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D020802:Epidural Abscess / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D020227:Lateral Sinus Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000473:pathology*; D008417:Mastoiditis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Intracranial Extradural Abscess; Lateral Sinus Thrombosis; Mastoiditis; Otitis Media