Tinjauan Pustaka: Diagnosis Dan Tatalaksana Mastoidits

Mastoiditis is a disorder of the middle ear. Inflammation of the middle ear involves the mastoid cells of the temporal bone. Mastoiditis is generally a complication of otitis media. This is due to the connection between the middle ear and the mastoid air cells. This research method begins by searching articles on Google Scholar, PubMed and NCBI within the year range determined by the researcher and using the keywords Mastoiditis, Mastoiditis Diagnosis, Mastoiditis Management. The results of this study found that the diagnosis of mastoiditis can be made by history, physical examination and supporting examinations. Treatment that can be done in mastoiditis depends on the severity of the infection and its complications. administration of antibiotics, incision and drainage of mastoid abscess and mastoidectomy are the management of mastoiditis &nbsp

An unusual complication of otitis media: Luc's abscess

Luc’s abscess is an extremely rare complication of otitis media, caused by the spread of the middle ear infection to the subperiosteal area and its accumulation beneath the temporal muscle. Unlike other subperiosteal abscesses relating to otitis media, infection may not be associated with mastoid bone involvement. Therefore, it is defined as a benign complication of otitis media. However, its rare occurrence may lead to delayed diagnosis and treatment. Here we report a case of an 11-year-old boy diagnosed with Luc’s abscess with mastoid involvement. We discuss its clinical presentation and treatment with a review of the literature. © 2018 by The European Academy of Otology and Neurotology and The Politzer Society

Physical Therapy Management Of A Patient With Unilateral Headache, Neck, And Shoulder Pain Who Presents With Undiagnosed Mastoiditis: A Case Report

Mastoiditis is an infection and inflammation of the mastoid cells. If left untreated, mastoiditis can lead to intracranial complications and ultimately death. Diagnosis is confirmed with imaging such as computed tomography or magnetic resonance imaging. Common symptoms include earache, retroauricular pain, headache, mastoid tenderness, hearing loss, and discharge from the ear. Mastoiditis is typically managed with antibiotics, but may require mastoidectomy which is the surgical removal of the mastoid bone. The purpose of this case report is to illuminate the signs/symptoms of Mastoiditis as well as Cervicogenic Headaches and their commonalities which include overlapping site of cervicalgia.https://dune.une.edu/pt_studcrposter/1186/thumbnail.jp

Severe infections of Panton-Valentine leukocidin positive Staphylococcus aureus in children

Infections caused by Panton-Valentine leukocidin-positive Staphylococcus aureus (PVL-SA) mostly present as recurrent skin abscesses and furunculosis. However, life-threatening infections (eg, necrotizing pneumonia, necrotizing fasciitis, and osteomyelitis) caused by PVL-SA have also been reported.We assessed the clinical phenotype, frequency, clinical implications (surgery, length of treatment in hospitals/intensive care units, and antibiotic treatments), and potential preventability of severe PVL-SA infections in children.Total, 75 children treated for PVL-SA infections in our in- and outpatient units from 2012 to 2017 were included in this retrospective study.Ten out of 75 children contracted severe infections (PVL-methicillin resistant S aureus n = 4) including necrotizing pneumonia (n = 4), necrotizing fasciitis (n = 2), pyomyositis (n = 2; including 1 patient who also had pneumonia), mastoiditis with cerebellitis (n = 1), preorbital cellulitis (n = 1), and recurrent deep furunculosis in an immunosuppressed patient (n = 1). Specific complications of PVL-SA infections were venous thrombosis (n = 2), sepsis (n = 5), respiratory failure (n = 5), and acute respiratory distress syndrome (n = 3). The median duration of hospital stay was 14 days (range 5-52 days). In 6 out of 10 patients a history suggestive for PVL-SA colonization in the patient or close family members before hospital admission was identified.PVL-SA causes severe to life-threatening infections requiring lengthy treatments in hospital in a substantial percentage of symptomatic PVL-SA colonized children. More than 50% of severe infections might be prevented by prompt testing for PVL-SA in individuals with a history of abscesses or furunculosis, followed by decolonization measures

Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children

Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.Peer reviewe

Clinic manifestations in granulomatosis with polyangiitis

Granulomatosis with polyangiitis (GPA), formerly Wegener's granulomatosis (WG), is an uncommon immunologically mediated systemic small-vessel vasculitis that is pathologically characterised by an inflammatory reaction pattern (necrosis, granulomatous inflammation and vasculitis) that occurs in the upper and lower respiratory tracts and kidneys. Although the aetiology of GPA remains largely unknown, it is believed to be autoimmune in origin and triggered by environmental events on a background of genetic susceptibility.In Europe, the prevalence of GPA is five cases per 100,000 population, with greater incidence in Northern Europe. GPA can occur in all racial groups but predominantly affects Caucasians. Both sexes are affected equally. GPA affects a wide age range (age range, 8-99 years).Granulomatosis with polyangiitis is characterised by necrotising granulomatous lesions of the respiratory tract, vasculitis and glomerulonephritis. Classically, the acronym ELK is used to describe the clinical involvement of the ear, nose and throat (ENT); lungs; and kidneys. Because the upper respiratory tract is involved in 70-100% of cases of GPA, classic otorhinolaryngologic symptoms may be the first clinical manifestation of disease. The nasal cavity and the paranasal sinuses are the most common sites of involvement in the head and neck area (85-100%), whereas otological disease is found in approximately 35% (range, 19-61%) of cases.Diagnosis of GPA is achieved through clinical assessment, serological tests for anti-neutrophil cytoplasmic antibodies (ANCA) and histological analysis. The 10-year survival rate is estimated to be 40% when the kidneys are involved and 60-70% when there is no kidney involvement.The standard therapy for GPA is a combination of glucocorticoids and cyclophosphamide. In young patients, cyclophosphamide should be switched to azathioprine in the maintenance phase.A multidisciplinary approach, involving otorhinolaryngologists, oral and maxillofacial surgeons, oral physicians, rheumatologists, renal and respiratory physicians, and ophthalmologists, is necessary for the diagnosis and therapeutic treatment of GPA. ENT physicians have a determining role in recognising the early onset of the disease and starting an appropriate therapy

Reimann's "Habitual Hyperthermia" Responding to Hormone Therapy.

A 25-year-old woman presented with fever of unknown origin, exhibiting malaise and low-grade fevers in evenings. These fevers exhibited a pattern of starting mid-menstrual cycle with resolution around the onset of menses, matching a pattern of "habitual hyperthermia" reported by H. Reimann in the 1930s. Extensive workup was unremarkable, and the fevers improved on oral synthetic estrogen and progesterone therapy

Acute mastoiditis in a child with a history of cochlear implantation : a case report

Background: Acute mastoiditis is one of the complications of acute otitis media in children. Patients with acute mastoiditis commonly have manifestations of acute otitis media and inflammation of the mastoid bone. Computed tomography is the most frequent diagnostic method for diagnosing acute mastoiditis. In this report, we presented a 6-year-old boy with a history of cochlear implantation three years ago, who was referred for acute swelling and pain in the mastoid bone one day ago.  Case presentation: A 6-year-old boy with fever, pain, redness, and swelling of the posterior side of his right ear from one day ago was referred to the clinic. Physical examination showed tenderness, redness, warmness, and swelling on the right auricle and mastoid bone. Implantation in the right ear about three years ago was mentioned. Last week, involvement with coryza, nasal congestion, and low-grade fever without ear pain was mentioned. Acute mastoiditis was confirmed with CT scanning, and he was cured with antibiotic therapy. Discussion: Acute mastoiditis is not common. It may occur after a few times of cochlear implantation, but it occurs rarely after a long time. The main cause is bacterial infection. After confirmation of the diagnosis with CT scanning, treatment with antibiotics should be started intravenously, and then it can be changed to oral antibiotics.     Conclusion: Acute mastoiditis should be considered as a differential diagnosis in pediatrics with acute swelling, pain, and any manifestation of inflammation on mastoid bone, even though there is no history of acute otitis media

Intratemporal complications of otitis media

Otitis media (OM) is considered a potentially severe disease due to the risk of complications. OBJECTIVE: To establish the annual incidence of intratemporal complications (ITC) resulting from OM and to prospectively assess patients for epidemiological and clinical factors. METHOD: This prospective cohort study included patients admitted during one year at a university hospital diagnosed with intratemporal complications of OM. Patients were analyzed for age, gender, type of intratemporal complication, treatment, and clinical outcome. The overall incidence of complications and the specific incidence rates of each type of complication were determined. RESULTS: 1,816 patients were diagnosed with OM; 592 (33%) had chronic OM; 1224 (67%) had acute OM. Fifteen patients were diagnosed with OM ITC, adding up to an annual incidence of 0.8%. Nineteen diagnoses of ITC were made in 15 patients. Seven (36.8%) patients were diagnosed with labyrinthine fistula, five (26.3%) with mastoiditis, four (21.1%) with peripheral facial palsy, and three (15.8%) with labyrinthitis. CONCLUSION: The incidence of intratemporal complications remains significant when compared to the rates seen in developed countries. Chronic cholesteatomatous otitis media is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.Otite média (OM) é considerada doença potencialmente grave em razão dos riscos de complicações que podem ocorrer em sua evolução. OBJETIVO: Estabelecer a incidência anual de complicações intratemporais de OM e avaliar prospectivamente os pacientes por meio da análise dos aspectos epidemiológicos e clínicos. MÉTODO: Estudo de coorte contemporânea. Durante o período de um ano, os pacientes admitidos em um Hospital Universitário, com diagnóstico de OM e de complicação intratemporal (CIT) de OM foram incluídos no estudo. Os dados avaliados foram: idade, sexo, tipo de complicação intratemporal, tratamento e desfecho clínico. A incidência geral das complicações e de cada complicação foi determinada. RESULTADOS: 1.816 pacientes foram diagnosticados com OM. Em 592 (33%) indivíduos, o diagnóstico foi de otite média crônica; em 1224 (67%) o diagnóstico foi de otite média aguda. CIT de OM foi diagnosticada em 15 pacientes, perfazendo uma incidência anual de CIT 0,8%. Foram identificados 19 diagnósticos de CIT em 15 pacientes. Fístula labiríntica foi diagnosticada em sete (36,8%) indivíduos, mastoidite em cinco (26,3%), paralisia facial periférica em quatro (21,1%) e labirintite em três (15,8%). CONCLUSÃO: A incidência das complicações intratemporais permanece significativa quando comparada à de países desenvolvidos. A otite média crônica colesteatomatosa é a etiologia mais frequente das complicações intratemporais. A fístula labiríntica é a complicação intratemporal mais comum.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)UNIFESP-EPM Departamento de OtorrinolaringologiaUNIFESP-EPMUNIFESP, EPM, Depto. de OtorrinolaringologiaUNIFESP, EPMSciEL

PERBANDINGAN HASIL PEMERIKSAAN RADIOLOGIK MASTOID DENGAN HASIL PEMERIKSAAN KLINIK PADA PENDERITA OTITIS MEDIA KRONIK AKTIF DENGAN DAN TANPA MASTOIDITIS

Background: Chronic Otitis Media (COM) is a chronic infection (more than 3 months) of half or entire middle ear cleft mucoperiosteum within prolonged tympanic membrane perforation and with or without history of otorrhea. COM defined as active if a discharge found during an examination. Like the other otitis media, COM has a potential to become complicated. The most frequent complication is mastoiditis. Mastoiditis is a bone inflammation (osteitis) of antrum wall and cellulae mastoid. Diagnosis of Mastoiditis is based on Ear Nose Throat clinical examination and Radiologic examination. The purpose of this research is to compare between Radiologic examination result on active COM patients and its Ear Nose Throat clinical examination result. Methods: An observational analytic study with cross sectional approach, using 30 COM patients who fulfilled clinical criteria as a sample. Sample was taken from copying the medical record at Bagian Rekam Medik Instalasi Rawat Jalan RSUP Dr. Kariadi Semarang. The research was conducted from March until June 2008. The data was analyzed using Kappa statistic test to measure the agreement between two nominal variables (radiologic examination result and Ear Nose Throat clinical examination result). Result: According to Kappa statistic test analysis, the score of Ear Nose Throat clinical examination result and the Radiologic examination result produced value of 0.039. Conclusion: Ear Nose Throat clinical examination result and Radiologic examination result on COM patients with or without mastoiditis had a bad agreement value. Keywords: Chronic Otitis Media, Mastoiditi