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