Acute Otomastoiditis in Children: therapeutic care

Acute mastoiditis is the most common complication of acute otitis media (AOM). It is a medical emergency. Our objectives were to evaluate our treatment approach and to determine the surgical indications for acute mastoiditis in children.Methods: A retrospective longitudinal study including 30 cases of acute mastoiditis managed by the otolaryngology department at Med Taher Mâamouri Hospital between 2017 and 2022.Results: All children were hospitalized. Parenteral antibiotic therapy was initiated upon admission at a non-meningitis dose in cases of periostitis and at a meningitis dose in cases of complicated mastoiditis. Cases of mastoiditis with subperiosteal abscesses received dual therapy; in cases of extrapetrous complications, we prescribed triple therapy. For first-line surgical treatment: ten cases of periosteal inflammation underwent trans-tympanic aeration; seven patients underwent drainage of a subperiosteal abscess; and one patient underwent a mastoidectomy with placement of an aeration tube. A mastoidectomy was indicated as a secondary treatment in two cases following the failure of conservative management.