Treatment of Acute Mastoiditis with Subperiosteal Abscess;Is the Mastoidectomy Necessary?

Chang, Ki Hong; Lee, Jeong Hak; Hwang, Sung Jae; Jun, Beom Cho; Park, So Young; Yeo, Sang Won

Abstract

BACKGROUND AND OBJECTIVES
Subperiosteal abscess, the most common complication of acute mastoiditis, has traditionally been treated with mastoidectomy. We aimed in this study to investigate the effectiveness of mastoidectomy in the management of acute mastoiditis with subperiosteal abscess. SUBJECTS AND METHOD: We reviewed restrospectively the charts of 19 patients who had been admitted to our hospitals with acute mastoiditis complicated with subperiosteal abscess during the years 1994-2004. RESULTS: All patients received intravenous antibiotics. While the mastoidectomy with ventilation tube insertion was done in 13 cases, 5 cases received incision and drainage of the abscess with ventilation tube insertion. In one patient who developed a subperiosteal abscess after the resolution of acute mastoiditis, only incision and drainage of the abscess was done. All cases showed complete recovery. CONCLUSION: Incision and drainage of the abscess accompanied by application of intravenous anti-biotics and ventilation tube would be an appropriate treatment for acute mastoiditis with subperiosteal abscess instead of routine mastoidectomy. or in cases with no evidence of facial nerve palsy, cholesteatoma and intracranial complications such as meningitis, cerebral abscess and sigmoid sinus thrombophlebitis etc.