Mastoiditis CT
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Mastoiditis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]
Overview
CT
CT findings in children with acute mastoiditis include [1][2][3]
[1,4,5,25,48]:
●Fluid and/or mucosal thickening in the middle ear and mastoid (clouding); this is a nonspecific finding that occurs early in the course; it is often seen in children with AOM without mastoiditis and may even be observed as an incidental finding in asymptomatic children. As an isolated finding, clouding of the mastoid does not indicate mastoiditis [49].
●Loss of definition of the bony septae that define the mastoid air cells (coalescent mastoiditis (image 1)); this finding is diagnostic of mastoiditis.
●Destruction or irregularity of the mastoid cortex (image 2).
●Periosteal thickening, disruption of the periosteum, subperiosteal abscess
•partial-to-complete opacification of the mastoid air cells, sometimes of the middle ear cleft as well •erosion of mastoid air cell bony septum may be present in coalescent mastoiditis Chronic
The term encompasses a number of conditions: • tympanic membrane changes: thickening, retraction, tympanic membrane perforation or calcification (myringosclerosis) • mastoid process changes: underdeveloped pneumatisation, sclerosis or opacification • middle ear changes:◦ middle ear atelectasis/ effusion/ granulation tissue ◦noncholesteatomatosis ossicular chain and tympanic cavity erosions ◦ossicular chain fixation ◦tympanosclerosis ◦acquired cholesteatoma ◦cholesterol granuloma
References
- ↑ Lin HW, Shargorodsky J, Gopen Q (2010). "Clinical strategies for the management of acute mastoiditis in the pediatric population". Clin Pediatr (Phila). 49 (2): 110–5. doi:10.1177/0009922809344349. PMID 19734439.
- ↑ Stähelin-Massik J, Podvinec M, Jakscha J, Rüst ON, Greisser J, Moschopulos M, Gnehm HE (2008). "Mastoiditis in children: a prospective, observational study comparing clinical presentation, microbiology, computed tomography, surgical findings and histology". Eur. J. Pediatr. 167 (5): 541–8. doi:10.1007/s00431-007-0549-1. PMID 17668240.
- ↑ Trojanowska A, Drop A, Trojanowski P, Rosińska-Bogusiewicz K, Klatka J, Bobek-Billewicz B (2012). "External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms". Insights Imaging. 3 (1): 33–48. doi:10.1007/s13244-011-0126-z. PMC 3292638. PMID 22695997.