小儿急性乳突炎：有颅内并发症和无颅内并发症患者的比较

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-03-30 DOI:10.1016/j.ijporl.2025.112329

Richmond Laryea , Wynne Zhang , Mica Glaun , Jae Eun Lee , Justin Dat Nguyen , Matthew S. Sitton , Elton M. Lambert

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引用次数: 0

摘要

目的探讨小儿急性乳突炎伴及不伴颅内并发症（ICC）的临床特点。方法回顾性分析2012年至2020年在某儿科三级保健中心就诊的诊断为乳突炎的患儿。所有患者均有微生物培养记录。患者间比较的主要因素为培养菌分离、抗生素耐药性、乳突炎颅内并发症的发生。结果298例乳突炎患者入组，平均年龄8.6岁（SD = 4.45）。其中41例患者出现至少一种颅内并发症（ICC），最常见的是硬膜外脓肿（51%）。143例（48%）患者就诊前有急性中耳炎病史，38例（13%）患者就诊前有慢性中耳炎病史。与没有耳部感染史的患者相比，有急性中耳炎病史的患者发生ICC的可能性更小OR: 0.49 (95% CI = 0.24-0.99), p = 0.047。与没有耳部感染史的患者相比，有慢性中耳炎病史的患者发生ICC的可能性更小OR: 0.20 (95% CI = 0.04-0.90), p = 0.036。与抗生素患者相比，使用抗生素的患者更容易发生ICC naïve OR: 2.64 (95% CI = 1.31-5.32) p = 0.006。患者性别和种族对ICC的发展也没有显著影响。结论无耳科感染史的乳突炎患者颅内并发症发生率较高。此外，在既往使用过抗生素的患者中，ICC的发生率较高。证据等级：四级证据等级：四级

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Pediatric acute mastoiditis: A comparison of patients with and without intracranial complications

Objective

To assess pediatric patients presenting with acute mastoiditis with and without intracranial complications (ICC)

Methods

A case series with retrospective review was performed on pediatric patients who presented to a pediatric tertiary care center with the diagnosis of mastoiditis from 2012 to 2020. All patients had a documented microbiology culture. The main factors compared among patients were bacteria isolated from cultures, antibiotic resistance, and occurrence of intracranial complications of mastoiditis.

Results

298 patients with mastoiditis were included in this study with an average age of 8.6 years (SD = 4.45). 41 of those patients presented with at least one intracranial complication (ICC) with the most common being epidural abscess (51 %). 143 (48 %) of patients had a history of acute otitis media prior to presentation, and thirty-eight patients (13 %) had a history of chronic otitis media prior to presentation. Patients with a history of acute otitis media were less likely to develop ICC compared to patients without a history of otologic infections OR: 0.49 (95 % CI = 0.24–0.99), p = 0.047. Patients with history of chronic otitis media were less likely to develop ICC compared to patients with no history of otologic infections OR: 0.20 (95 % CI = 0.04–0.90), p = 0.036. Patients with antibiotic use were more likely to develop ICC compared to antibiotic naïve patients OR: 2.64 (95 % CI = 1.31–5.32) p = 0.006. There was also no significant effect of patient sex, and ethnicity in the development of ICC.

Conclusion

The occurrence of intracranial complications from mastoiditis are noted to be higher in patients with no history of otologic infections. Additionally, the occurrence of ICC is noted to be higher among patients with prior antibiotic use.

Level of evidence: level 4

Level of evidence

level 4

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.