Evidence map›Paper›PMID 40993659›Full record

ArticleItalian journal of pediatrics2025

Management of acute mastoiditis in children: a retrospective analysis.

Marella Reale, Carlotta Montagnani, Pietro Orlando, Luca Mazzetti, Marco Trinci, Luca Leone, Mariapaola Guidi, Giuseppe Indolfi, Sandra Trapani, Franco Trabalzini and 1 more

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In one paragraph

Article in Italian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Marella RealeOtorhinolaryngology Unit, Head and Neck Department, Meyer Children's Hospital IRCCS, Florence, Italy.
Carlotta MontagnaniInfectious Diseases Unit, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy. carlotta.montagnani@meyer.it.ORCID http://orcid.org/0000-0001-5950-4965
Pietro OrlandoDepartment of Otorhinolaryngology, Careggi University Hospital, Florence, Italy.
Luca MazzettiDepartment of Otorhinolaryngology, Careggi University Hospital, Florence, Italy.
Marco TrinciDepartment of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
Luca LeoneOtorhinolaryngology Unit, Head and Neck Department, Meyer Children's Hospital IRCCS, Florence, Italy.
Mariapaola GuidiOtorhinolaryngology Unit, Head and Neck Department, Meyer Children's Hospital IRCCS, Florence, Italy.
Giuseppe IndolfiDepartment of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
Sandra TrapaniDepartment of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
Franco TrabalziniOtorhinolaryngology Unit, Head and Neck Department, Meyer Children's Hospital IRCCS, Florence, Italy.
Luisa GalliInfectious Diseases Unit, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute mastoiditis (AM) is the most common complication of acute otitis media (AOM) and could lead to serious complications if not diagnosed early and treated appropriately. Nowadays, there is no definitive consensus about the diagnostic algorithm and the optimal therapeutic management for patients with AM. The purpose of this study is to analyze the management of children admitted for AM and complicated AM (CAM) in a referral children's hospital, evaluating differences in clinical presentation and management to outline a diagnostic and therapeutic pathway. Moreover, the incidence over time was assessed.

methodsRetrospective study of children admitted for AM at Meyer University Hospital- IRCCS, Florence from January 2016 to December 2023.

resultsEighty-five patients were included in the study (60% male, median age 4 years), the microbiological examinations were carried out in 68% of them. The most frequent isolated pathogens were Pseudomonas aeruginosa in AM and Streptococcus pyogenes in CAM. Seventeen patients developed a CAM. An elevated CRP value is associated with an increased risk of CAM (p = 0.043). Management of patients with AM was mainly medical with intravenous antibiotics. Surgical intervention was required only in one case (1 out of 68). In contrast, surgical intervention was required in 76% of CAM cases (13 out of 17). The most common procedure was mastoidectomy combined to abscess drainage, according to the predominance of this complication in our study group. Only one patient had a recurrence leading to a second surgery. No significant statistical correlation was found between the occurrence of complications and younger age, personal history of otitis or leukocyte count. A significant increase in AM case was found during the study period.

conclusionsAM and CAM are infrequent but potentially life-threatening complications of AOM. A marked rise in AM cases was observed in 2023, likely due to the lifting of pandemic restrictions. A heterogeneous management of mastoiditis was observed, even within a single center. Elevated CRP levels are the only identified parameter associated with the complicated form. Pediatricians should be aware of the importance of a prompt diagnosis and guidelines should be developed to support effective management.

Indexed as

Anti-Bacterial AgentsMastoiditisOtitis MediaAcute DiseaseAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesAnti-Bacterial AgentsAcute mastoiditisAcute otitis mediaChildrenComplicated acute mastoiditis

Identifiers

PMID40993659
PMCPMC12462347

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