Outcomes and Prognostic Factors of Acute Mastoiditis in the Grand-Est Region

Évaluation Des Facteurs Pronostiques et de l'évolution Des mastoïdites aigües Dans la région Grand-Est

There is an increased incidence of acute mastoïditis and a lack of homogeneity in management. The investigator aim to refine the epidemiological knowledge on this pathology.

Data of children with acute mastoiditis of the last ten years in five hospitals of the North-East of France (University Hospitals of Nancy, Strasbourg, Dijon, Besançon and the Regional Hospital of Metz-Thionville) will be analyzed.

Acute mastoiditis is a bacterial infection of the middle ear cavities, associated with destructive damage of the mastoid bone, complicating acute otitis media. It affects infants and young children and its complications can be serious, including neurological sequelae.

These complications can be divided into two categories according to their topography:

• intracranial complications : thrombophlebitis, meningitis, epidural abscess, and cerebral empyema.
• Extracranial complications subperiosteal abscess, Bezold's abscess, peripheral facial paralysis, labyrinthitis, and temporomandibular joint arthritis.

Incidence ranges from 1.2 to 6 per 100,000 children per year, with a trend of increasing cases with the increase in the proportion of Fusobacterium Necrophorum infections, described as frequent provider of complications. This observation is shared by the ENT practitioners of the CHRU of Nancy.

The management of mastoiditis is medico-surgical, but the therapeutic algorithms vary according to the centers and countries. The exact place of surgery is discussed in uncomplicated cases, despite recent meta-analyses. In France, no therapeutic algorithm is currently proposed by ENT societies.

Given this double observation of increased incidence and lack of homogeneity in the management of mastoiditis, it appears to be useful to refine the epidemiological knowledge on this pathology.

Therefore, we will analyze data of children with acute mastoiditis of the last ten years in five hospitals of the North-East of France : University Hospitals of Nancy, Strasbourg, Dijon, Besançon and the Regional Hospital of Metz-Thionville.

Inclusion Criteria:

• All patients under 15 years of age
• Supported in one of the ENT or pediatric services of the four investigation centers
• Between January 1, 2014 and July 31, 2024
• With a diagnosis of acute mastoiditis

Exclusion Criteria:

• Patient with history of cholesteatoma or cochlear implantation