Key points:
1. Thirty-three patients with complicated acute mastoiditis from a
tertiary medical center were included in this retrospective cohort
study.
2. Patients were divided into two study groups: Patients with
sub-periosteal abscess alone- single compilation group, and patients
with additional complications- multiple complication group.
3. Post-operative fever after cortical mastoidectomy due to complicated
acute mastoiditis seems to be a benign condition in the 5-6 days
postoperative period
4. The multiple complication group exhibited higher and prolonged
post-operative fever compared to single complication cases.
1. Introduction
The most Common complications seen in children with acute mastoiditis
include sub-periosteal abscess (SPA), sigmoid sinus thrombosis (SST),
peri-sinus fluid/abscess, epidural, subdural abscess, and acute
meningitis (1-2). These complications are diagnosed
both, clinically and radiologically (3). Cortical
mastoidectomy with ventilation tube insertion has a vital role in
treating complicated mastoiditis (CAM), along with antibiotics(4), antipyretics, and anticoagulation, in cases of
SST (5).
The management of a febrile child with CAM regardless of clinical
improvement becomes challenging. In such cases, repeated imaging and
revision surgery should be considered. However, imaging in such
circumstances possesses several limitations; Post-contrast head CT in
children usually requires general anesthesia and is associated with
substantial ionizing radiation. Head MRI is superior over CT for
evaluating soft tissue details such as of peri-sinus abscess and
presence of SST but is less available, costly, and requires an extended
general anesthesia period.
The main aim of the present study was to characterize the incidence and
course of post-operative fever (POF) in children with CAM following
surgery