Management of paediatric acute mastoiditis: systematic review

BACKGROUND: Acute mastoiditis remains the commonest intratemporal complication of otitis media in the paediatric population. There has been a lack of consensus regarding the diagnosis and management of acute mastoiditis, resulting in considerable disparity in conservative and surgical management. OBJECTIVES: To review the current literature, proposing recommendations for the management of paediatric acute mastoiditis and appraising the treatment outcomes. METHOD: A systematic review was conducted using PubMed, Web of Science and Cochrane Library databases. RESULTS: Twenty-one studies were included, with a total of 564 patients. Cure rates of medical treatment, conservative surgery and mastoidectomy were 95.9 per cent, 96.3 per cent and 89.1 per cent, respectively. CONCLUSION: Mastoidectomy may be the most definitive treatment available; however, reviewed data suggest that conservative treatment alone has high efficacy as first-line treatment in uncomplicated cases of acute mastoiditis, and conservative therapy may be an appropriate first-line management when treating acute mastoiditis.