Dhooge I J, Vandenbussche T, Lemmerling M
University Hospital, Department of Otorhinolaryngology, Ghent, Belgium.
Rev Laryngol Otol Rhinol (Bord). 1998;119(2):91-4.
In this study we report our experience with 24 patients with acute mastoiditis treated at the University Hospital in Ghent, Belgium. The most common presenting signs and symptoms of acute mastoiditis were an abnormal tympanic membrane (21/24), otorrhea (17/24) and earache (13/24). Postauricular edema and erythema with protrusion of the ear, often used as a diagnostic criterion, was present in only 3 patients. Demineralisation of the trabeculae was the most frequent radiological finding (13/24). Based on CT findings a distinction was made between two groups: acute incipient mastoiditis (13/24) and acute coalescent mastoiditis (5/24). Thirteen patients recovered with conservative therapy consisting of IV antibiotics and early myringotomy with or without placement of a ventilation tube. Mastoidectomy was required in 11 patients. Nine patients presented with a complication of infection extending beyond the mastoid compartment. The results are discussed and the value of CT scanning as a diagnostic tool and decisive element in the choice of therapy is analysed.
在本研究中，我们报告了在比利时根特大学医院治疗的24例急性乳突炎患者的治疗经验。急性乳突炎最常见的体征和症状为鼓膜异常（21/24）、耳漏（17/24）和耳痛（13/24）。常被用作诊断标准的耳后水肿、红斑伴耳部突出仅见于3例患者。小梁脱矿是最常见的影像学表现（13/24）。根据CT表现将患者分为两组：急性早期乳突炎（13/24）和急性融合性乳突炎（5/24）。13例患者通过静脉使用抗生素及早期鼓膜切开术（伴或不伴放置通气管）的保守治疗得以康复。11例患者需要进行乳突切除术。9例患者出现了感染并发症，感染范围超出乳突腔。我们对结果进行了讨论，并分析了CT扫描作为诊断工具以及在治疗选择中决定性因素的价值。
