BACKGROUND: An increasing number of pediatric patients with mastoiditis and a consequent increase in mastoidectomy rates was noted in 2022 and 2023.
OBJECTIVE: This study aimed to analyze the increase in the number of children presenting with mastoiditis and subsequent mastoidectomy, to assess correlations with prior antibiotic treatment or COVID-19 infection, and to provide an overview of involved pathogens, treatment, and disease course.
METHODS: A retrospective analysis of all patients with mastoidectomy since 2012 was conducted. Data collected comprised type and duration symptoms, prior antibiotic therapy, diagnostic tests and disease course, causal pathogens, length of hospitalization, and complications.
RESULTS: A highly significant increase in mastoidectomies in children could be demonstrated from 2022. Neither the pathogens involved nor the course of disease or complications showed differences. An increase in the number of patients with prior outpatient antibiotic therapy could be shown. About a half of the patients becoming ill after fall 2022 had a positive history of COVID. Hyperplasia of adenoid tissue was a far less frequent causal mechanism than in the years before COVID.
CONCLUSIONS: No clear correlation with reduced outpatient antibiotic therapy could be found. Whether there exists an association with prior COVID infection cannot be judged at this time, due to the high number of asymptomatic and therefore unknown COVID infections.
UNASSIGNED: HINTERGRUND: In den Jahren 2022 und 2023 wurde eine steigende Anzahl an Mastoiditiden bei Kindern und damit auch ein Anstieg der Mastoidektomien bei Kindern beobachtet.
UNASSIGNED: Ziel der vorliegenden Arbeit war es, den Anstieg der Anzahl an Patienten mit Mastoiditis und folgender Mastoidektomie zu analysieren, Korrelationen mit vorheriger Antibiotikatherapie und COVID-Infektionen zu untersuchen und einen Überblick über Keimspektrum, Krankheitsverlauf und Therapie zu geben.
METHODS: Dazu wurde eine retrospektive Analyse aller seit 2012 behandelten Patienten mit Mastoiditis durchgeführt, bei denen eine Mastoidektomie durchgeführt werden musste. Evaluiert wurden Art und Dauer vorangegangener Symptome und einer vorherigen Antibiotikatherapie, Diagnostik und Krankheitsverlauf sowie Keimspektrum, Dauer des Krankenhausaufenthalts und Komplikationen.
UNASSIGNED: Es wurde ein hoch signifikanter Anstieg an Mastoiditiden und somit auch an Mastoidektomien ab 2022 gezeigt. Weder Keimspektrum noch Krankheitsverlauf oder Komplikationsrate unterschieden sich von den vorherigen Jahren mit niedrigerer Inzidenz. Eher konnte eine Zunahme bereits ambulant antibiotisch vortherapierter Patienten gezeigt werden. Etwa die Hälfte der seit Herbst 2022 erkrankten Patienten hatte eine positive COVID-Anamnese. Adenoidhyperplasie spielte ursächlich eine deutlich geringere Rolle als in den Jahren zuvor.
UNASSIGNED: Eine Korrelation zu reduzierter ambulanter Antibiotikagabe erscheint bei in diesem Kollektiv eher steigender Anzahl somit kausal als unwahrscheinlich. Ob ein Zusammenhang mit einer durchgemachten COVID-Infektion besteht, kann aufgrund der hohen Dunkelziffer bei asymptomatischen und nicht nachgewiesenen Fällen nicht abschließend beurteilt werden.

UNASSIGNED: The optimal timing for surgery to promote postoperative recovery in children with congenital stenosis of the external auditory canal with external auditory canal cholesteatoma, who are susceptible to exudative inflammation of middle ear and mastoid process, is still uncertain.
UNASSIGNED: To investigate the treatment of congenital stenosis of external auditory canal with external auditory canal cholesteatoma complicated with exudative inflammation.
UNASSIGNED: A retrospective analysis of 45 patients with congenital stenosis of external auditory canal with external auditory canal cholesteatoma complicated with mastoiditis. Based on whether effusion had resolved at the time of surgery, the patients were divided into two groups. Pure-tone audiometry tests were performed before and after surgery for both groups.
UNASSIGNED: The average postoperative duration of dry ear was 36.38 days in Group 1 and 47.90 days in Group 2 (p < 0.05). Among patients who underwent hearing reconstruction, the average air conduction threshold decreased by 15-36 dBHL in Group 1 and by 7-22 dBHL in Group 2 (p < 0.05).
UNASSIGNED: The postoperative outcomes of dry ear and hearing improvement can be enhanced by performing operation after effusion resolution in cases of congenital external auditory canal stenosis with external auditory canal cholesteatoma exudative inflammation.

UNASSIGNED: To evaluate and compare children undergoing cochlear implantation (CI) with myringotomy tubes (MT) placed preoperatively or intraoperatively to those without MT .
UNASSIGNED: This was a retrospective review of pediatric patients undergoing CI between 2015 to 2020 at a tertiary care pediatric hospital. CI patients with and without MT were reviewed for the following outcomes: intraoperative findings, intraoperative and postoperative complications, and surgical time. Descriptive and bivariable statistical analysis was performed.
UNASSIGNED: 192 cochlear implant surgeries were included: 116 without MT tubes and 76 with a history of MT. Twenty-six patients had MT present at the time of CI surgery. No statistical difference existed between patients with MT (CI + MT group) and those without MT (CI - MT group) with regard to intraoperative complications (P = 0.760) and intraoperative findings (P = 0.545). MT association with total post-operative complications (GEE) showed no statistical significance (OR 2.45, 95% CI 0.83-7.22, P-value 0.105). CI + MT patients were significantly more likely to have inflamed middle ear mucosa at time of surgery (P = 0.003). CI + MT patients did not have a longer length of surgery compared to the CI - MT group (3.47 h vs 3.3 h, respectively, P = 0.342).
UNASSIGNED: Our data confirms it is safe to perform CI in ears with myringotomy tubes, although the surgeon should be aware of possibly encountering increased middle ear inflammation during the surgery.

Acute otitis media (AOM) is one of the most common ENT diseases in children. In the antibiotic/post-antibiotic era, facial paralysis is a very rare complication of AOM (0.004-0.005%). Despite the rarity of this complication, it should be known by all physicians for proper therapeutic management to avoid serious sequelae. The aim of this review is to provide a management guide based on the current literature.
METHODS: Fifteen studies published between 2000 and 2022 were selected, including 120 patients (62 M/58 F) with an average age of 4.96 years old (range = 4 months-16 years; SD: 4.2). The paralysis frequently has a sudden onset and is of a severe grade (medium House-Brackmann (HB) score at onset: 4.68; SD: 0.5); however, it tends to have an almost complete recovery in most patients (88.49% HB 1 at follow-up).
RESULTS: Its first-line treatment must be based on the use of antibiotics (beta-lactam antibiotics as penicillins or cephalosporins). Corticosteroids should be used concomitantly for their anti-inflammatory and neuroprotective actions; however, there is no unanimity between authors about their application. Myringotomy, with or without ventilation tube insertion, is indicated in cases where the tympanic membrane is intact. Other kinds of surgery should be performed only in patients who have a worsening of their AOM symptoms or a worsening in HB score even with clinical treatment.
CONCLUSIONS: The obtained data show that a conservative treatment can be sufficient for complete recovery in most patients, and it is preferred as the first-line therapy. Mastoidectomy should be performed only in patients with acute mastoiditis and without symptom improvement after a conservative approach. There are insufficient data in the current literature to provide clear selection criteria for patients who need to undergo mastoidectomy with facial nerve decompression. The choice of this treatment is based on an individual center expertise. Further studies are needed to clarify the role of corticosteroids and the role of facial nerve decompression in this clinical scenario.