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Post-operative clinical course in children undergoing mastoidectomy due to complicated acute mastoiditis

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) following surgical treatment.

Methods

A retrospective chart review of children diagnosed with CAM who underwent mastoid surgery during 2012–2019 in a tertiary care university hospital. 33 patients, divided into 2 groups: 17 patients with sub-periosteal abscess (SPA) alone–single complication group (SCG) and 16 patients with SPA and additional complications: sigmoid sinus thrombosis (SST), peri-sinus fluid/abscess, epidural/subdural abscess, and acute meningitis-multiple complications group (MCG).

Results

33 patients belong to the SCG 17(51%) and 16(49%) belonged to the MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs. 12/16(75%) in the MCG (P = 0.012). At post-operative day 2 (POD2), 10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG (P = 0.013). POF was recorded until POD6 in both groups. Seven patients, all from MCG with POF, underwent second imaging with no new findings; a total of 18 positive cultures were reported. Fusobacterium necrophorum counted for 8/18(44.5%) of all positive cultures, 7/9(77.8%) in the MCG vs. 1/9(11.1%) in the SCG, P = 0.004. Streptococcus pneumoniae was reported only in SCG (5/9, 55.5%, vs. 0/9, P = 0.008).

Conclusion

Post-mastoidectomy fever due to CAM is not unusual and seems to be a benign condition for the first 5–6 days, following surgery. MCG patients are more prone to develop POF. F. necrophorum is more likely to be associated with MCG, and S. pneumoniae is common in SCG patients.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Oren Ziv and Aviad Sapir contributed equally to the present study.

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Ben-Gurion University, Beer-Sheva, Israel

    Oren Ziv, Aviad Sapir, Sofia Kordeluk, Daniel M. Kaplan & Sabri El-Saied

  2. Pediatric Infectious Disease Unit, Ben-Gurion University, Beer-Sheva, Israel

    Eugene Leibovitz

  3. ENT Department, Soroka University Medical Center, 151, Beer Sheva, Israel

    Oren Ziv, Aviad Sapir, Eugene Leibovitz, Sofia Kordeluk, Daniel M. Kaplan & Sabri El-Saied

  4. Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel

    Oren Ziv, Aviad Sapir, Eugene Leibovitz, Sofia Kordeluk, Daniel M. Kaplan & Sabri El-Saied

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  1. Oren Ziv
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  2. Aviad Sapir
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Correspondence to Aviad Sapir.

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Ziv, O., Sapir, A., Leibovitz, E. et al. Post-operative clinical course in children undergoing mastoidectomy due to complicated acute mastoiditis. Eur Arch Otorhinolaryngol 279, 3891–3897 (2022). https://doi.org/10.1007/s00405-021-07149-x

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  • DOI: https://doi.org/10.1007/s00405-021-07149-x

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