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DOI: 10.1148/rg.232025076
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(Radiographics. 2003;23:359-372.)
© RSNA, 2003

EDUCATION EXHIBIT

Imaging of Complications of Acute Mastoiditis in Children1

Elida Vazquez, MD, Amparo Castellote, MD, Joaquim Piqueras, MD, Susana Mauleon, MD, Santiago Creixell, MD, Felix Pumarola, MD, Concepción Figueras, MD, Juan-Carlos Carreño, MD and Javier Lucaya, MD

1 From the Departments of Pediatric Radiology (E.V., A.C., J.P., S.M., S.C., J.C.C., J.L.), Pediatric Otorhinolaryngology (F.P.), and Pediatric Infectious Diseases (C.F.), Hospital Universitario Vall d’Hebron, Area Materno-infantil, Psg Vall d’Hebron 119–129, E-08035 Barcelona, Spain. Presented as an education exhibit at the 2001 RSNA scientific assembly. Received April 8, 2002; revision requested July 23 and received November 13; accepted November 18. Address correspondence to E.V. (e-mail: evazquez@cs.vhebron.es).

Acute mastoiditis is a serious complication of acute otitis media in children. Suppurative disease in the mastoid region occasionally spreads to the adjacent dura mater of the posterior and middle cranial fossae and the sigmoid sinus by means of thrombophlebitis, osseous erosion, or anatomic pathways, producing intracranial complications. Computed tomography (CT) should be performed early in the course of the disease to classify the mastoiditis as incipient or coalescent and to detect intracranial complications. On the basis of the clinical features and imaging findings, the disease is managed conservatively with intravenously administered antibiotics or treated with mastoidectomy and drainage plus antibiotic therapy. CT is therefore a decisive diagnostic tool in determining the type of therapy. In addition, magnetic resonance imaging is performed in patients with clinical symptoms or CT findings suggestive of intracranial complications because of its higher sensitivity for detection of extraaxial fluid collections and associated vascular problems.

© RSNA, 2003

Index Terms: Children, infections, 214.26 • Ear, inflammation and infection, 214.26 • Temporal bone, abnormalities, 214.26




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