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<p>Acute mastoiditis is a&#xa0;rare but serious complication of acute otitis media in childhood. Despite numerous studies, clear and uniform guidelines for the definition, diagnosis and treatment are lacking. Based on a&#xa0;review of the available literature, the following recommendations can be made: the diagnosis is primarily based on clinical criteria and classical cardinal symptoms. In cases of unclear findings, suspected complications, poor general condition, lack of improvement after 24–48 h of treatment or prior to surgery, computed tomography (CT) or magnetic resonance imaging (MRI) is necessary. Acute mastoiditis is treated in an inpatient setting with an interdisciplinary approach. In addition to immediate intravenous antibiotic administration (first choice ampicillin-sulbactam), paracentesis should be liberally considered. Mastoidectomy is indicated in cases of complications or after a&#xa0;maximum of 48 h of conservative treatment without improvement. This article summarizes the heterogeneous data into a&#xa0;practical algorithm for children with acute mastoiditis.</p>

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Akute Mastoiditis bei Kindern

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • Stephan Hackenberg,
  • Agmal Scherzad,
  • Johannes Liese

摘要

Acute mastoiditis is a rare but serious complication of acute otitis media in childhood. Despite numerous studies, clear and uniform guidelines for the definition, diagnosis and treatment are lacking. Based on a review of the available literature, the following recommendations can be made: the diagnosis is primarily based on clinical criteria and classical cardinal symptoms. In cases of unclear findings, suspected complications, poor general condition, lack of improvement after 24–48 h of treatment or prior to surgery, computed tomography (CT) or magnetic resonance imaging (MRI) is necessary. Acute mastoiditis is treated in an inpatient setting with an interdisciplinary approach. In addition to immediate intravenous antibiotic administration (first choice ampicillin-sulbactam), paracentesis should be liberally considered. Mastoidectomy is indicated in cases of complications or after a maximum of 48 h of conservative treatment without improvement. This article summarizes the heterogeneous data into a practical algorithm for children with acute mastoiditis.