gms | German Medical Science

Latent mastoiditis might be defined as a subclinic infection of the mucosa and the bone structures of the middle ear cavity and of the mastoid cells which develops behind an apparently normal tympanic membrane. The aim of this study is to present some cases of latent mastoiditis revealed by a complication and thus to maintain a high interest among the ENT specialists beside the evolutive possibility of acute suppurate otitis media treated incorrect (low dosis, short course) with antibiotics. In the last three years we diagnosed and treated 14 children with masked mastoiditis. The children were between 1 and 4 years of age with a history of multiple antibiotics administration. The reasons of admission were: in all cases – fever syndrome of unknown origin associated with opaque tympanic membrane and in 5 cases because of associated complications (2 boys with retroauricular subperiosteal abscess and 3 girls with facial paralysis). In all cases we performed: otomycroscopic examination, CT-scans of the temporal bone, tympanocentesis – exploratory and for culture and sensitivity, bacteriological examination, hearing function assessment at admission and as well one month after the surgery. It is important to maintain a high suspicion of masked mastoiditis in children with slightly fever of unknown origin who were recently treated with different kind of antibiotics. The tympanic membrane appearance in masked mastoiditis may mislead or delay the diagnosis. The CT-scan is not able to offer specific details for a correct diagnostic. The only recommended treatment is the surgical procedure.

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