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Changes in Frequency Over Time

Marc C. Thorne, MD; Linda Chewaproug, MS; Lisa M. Elden, MD

Arch Otolaryngol Head Neck Surg. 2009;135(7):638-641.

Objective  To review the experience at the Children's Hospital of Philadelphia in the management of suppurative complications of acute otitis media from 2000 to 2007, with an emphasis on changes in frequency over time.

Design  Retrospective cohort study.

Setting  Academic, tertiary care children's hospital.

Patients  The study population comprised 87 children (age <18 years) with acute mastoiditis treated at our institution over the period of January 1, 2000, to December 31, 2007. Acute mastoiditis was defined by evidence of inflammation in the middle ear space and signs of mastoid inflammation (postauricular swelling, redness, or tenderness) or radiographic evidence of destruction of mastoid air cells, sigmoid sinus thrombosis, or abscess formation. Patients with underlying cholesteatoma were excluded.

Main Outcome Measure  Frequency of cases of acute mastoiditis per year.

Results  The frequency of cases of acute mastoiditis at our institution was positively correlated with calendar time, both for all cases of acute mastoiditis (Spearman rank correlation, r = 0.73; P = .04) and for cases of mastoid subperiosteal abscess (r = 0.96; P < .001).

Conclusions  We observed an increase in the frequency of cases of acute mastoiditis with subperiosteal abscess seen at our institution over the study period, controlling for case volume. These findings suggest an increase in incidence, although further population-based studies are required to definitively evaluate this possibility.

Author Affiliations: Division of Pediatric Otolaryngology, Department of Otolaryngology–Head and Neck Surgery, The University of Michigan, Ann Arbor (Dr Thorne); and Division of Otolaryngology, The Children's Hospital of Philadelphia, and Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia (Ms Chewaproug and Dr Elden).

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