Management of the mastoid — The UDT-system; a new classification in ear surgery

Abstract

The strategic location of the middle ear cleft and mastoid air cells makes every infection of the middle ear and mastoid capable of creating intracranial complications or complications of the middle ear cleft and of the mastoid, the facial nerve, the labyrinth and sigmoid sinus. With the advent of antibiotics the majority of patients with an acute otitis media are controlled by medical treatment. Only a few cases do not respond to this therapy and require surgery. Surgery is indicated when the acute symptoms have not been controlled by antibiotics and otorrhoea continues for 4 to 8 weeks after the onset of the disease or when the following complications are present, when the case is first seen:

• intracranial complications,

• subperiosteal or subcutaneous abscess in the postauricular region,

• Bezold’s abscess,

• labyrinthitis.