Rosen A, Ophir D, Marshak G
Ann Otol Rhinol Laryngol. 1986 May-Jun;95(3 Pt 1):222-4. doi: 10.1177/000348948609500302.
Sixty-nine cases of acute mastoiditis were managed at the Kaplan Hospital in Israel during a 10-year period. About two thirds (68%) recovered with conservative therapy consisting of wide myringotomy and intravenous antimicrobial therapy, usually ampicillin and cloxacillin. One third (22 patients) were managed surgically by complete mastoidectomy. Indications for surgery were subperiosteal abscess, based on clinical findings in 20 patients; one had septic fever that did not respond to antimicrobial therapy, and one had signs of meningeal irritation. Mastoid radiographs played no role in the decision to operate. Four cases of unsuspected epidural abscess were found, two behind intact tegmental bone. Acute mastoiditis develops mostly in ears that have not been immune to previous infections; thus the mucosal barrier is broken easily and osteitis occurs. Although with the advent of antimicrobial therapy the presentation and course of the disease are milder, the disease is still serious and potentially lethal.
在以色列的卡普兰医院，10年间共诊治了69例急性乳突炎患者。约三分之二（68%）的患者通过包括广泛鼓膜切开术和静脉抗菌治疗（通常为氨苄西林和氯唑西林）的保守治疗得以康复。三分之一（22例患者）接受了全乳突切除术的手术治疗。手术指征包括：20例患者根据临床检查发现有骨膜下脓肿；1例患者出现对抗菌治疗无反应的败血症热，1例患者有脑膜刺激征。乳突X光片在手术决策中未发挥作用。发现4例未被怀疑的硬膜外脓肿，其中2例位于完整的骨盖后方。急性乳突炎大多发生在既往未对感染产生免疫的耳部；因此，黏膜屏障容易被破坏，进而发生骨炎。尽管随着抗菌治疗的出现，该病的表现和病程较为轻微，但该疾病仍然严重且有潜在致命性。
