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. 2019 Dec;33(12):1158-1162.
doi: 10.13201/j.issn.1001-1781.2019.12.010.

[Clinical features of occult mastoiditis complicated with periphlcbitis of sigmoid sinus in children]

[Article in Chinese]
X Zhang  1 , M Chen  2 , J Zhang  2 , Y Yang  2 , Z Y Liu  2
Affiliations

[Clinical features of occult mastoiditis complicated with periphlcbitis of sigmoid sinus in children]

[Article in Chinese]
X Zhang et al. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Dec.

Abstract
in English, Chinese

Objective:To investigate the clinical characteristics and principle of treatment of occult mastoiditis accompanied with periphlcbitis of sigmoid sinus in pediatrics. Result:Four cases, with a short-time acute otitis media history, complained of headache / retroauricular pain, with papillary swelling, diagnosed as occult mastoiditis accompanied with periphlcbitis of sigmoid sinus according to the results of the temporal bone CT and MR. All of them had normal tympanic membrane, normal pure tone threshold, but type B tympanogram. CT scan of temporal bone showed soft tissue shadow of mastoid process, bone destruction of sigmoid sinus wall, and nuclear magnetic enhancement suggested cystic lesion behind mastoid process. With the usage of sufficient amount and anti-inflammatory antibiotics of permeable brain barrier, mastoidectomy were performed as early as possible. All the postoperative pathology showed inflammatory granulation, and no recurrence happened during the follow-up periods of 12-18 months. Conclusion:Intracranial complications in occult mastoiditis should be taken into account, with contemporary acute otitis media history, headache/retroauricular pain, and papillary swelling. Temporal bone image examination and hearing test should be done timely. Once the diagnosis was confirmed, on the basis of anti-infection treatment, the operation should be done as early as possible to to open the mastoid and improve the ventilation drainage of middle ear.

目的：探讨儿童隐匿性乳突炎合并乙状窦周围炎的临床特点及诊治原则。 方法：回顾性分析4例隐匿性乳突炎合并乙状窦周围炎患儿的临床资料。 结果：4例患儿均有短暂急性中耳炎病史，因间断头痛/耳后疼痛、乳突区肿胀就诊。查体：鼓膜大体正常，纯音听阈测试听力正常，声导抗B型；颞骨CT可见乳突软组织影，乙状窦壁骨质破坏，核磁增强提示乳突后方囊状病变，囊壁强化，乙状窦受压。在足量、透血脑屏障抗生素抗炎前提下尽早行乳突切开探查术。术后病理均为炎性肉芽，随访12~18个月无复发。 结论：短暂急性中耳炎病史、头痛/耳后疼痛伴乳突区肿胀时应考虑隐匿性乳突炎颅内并发症可能，需及时行颞骨影像学及听力检查以明确诊断。治疗原则是在抗感染治疗基础上尽早手术开放乳突，改善引流。.

Keywords: child; mastoiditis; periphlcbitis of sigmoid sinus.

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Conflict of interest statement

The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

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