Clinical analysis of 22 cases of acute suppurative otitis media complicating postauricular subperiosteal abscess in children
Objective To investigate the clinical characteristics and treatment of posterior subperiosteal abscess caused by acute suppurative otitis media in children.Methods The clinical data of 22 children with retroauricular subperiosteal abscess treated with surgery and conservative treatment from March 2010 to January 2023 were retrospectively analyzed.The causes,bacterial detection rate,bacterial classification,anatomic characteristics of middle ear,clinical characteristics and treatment plan were discussed.Results There was history of acute upper respiratory tract infection in all the children before the onset of the disease.Sixteen children with severe symptoms underwent postauricular abscess resection+intact canal wall mastoidectomy+superior tympanoplasty,while six children with relatively mild symptoms underwent conservative treatment with antibiotics+abscess puncture.The bacterial culture detection rate of pus or tissue with pus in the operative area was 81.3％(13/16)in 16 children undergoing surgical treatment,and 33.3％(3/6)in 6 children undergoing conservative treatment.The main pathogenic bacteria were streptococcus pneumoniae in 14 cases,bacillus proteus in 1 case,streptococcus pyogenes in 1 case,and no bacteria were detected in 6 cases.Conclusions Subtympanic abscess is secondary to acute suppurative otitis media.The main pathogen is Streptococcus pneumoniae.Pneumatized mastoid are found in all children with elevated tympanic cover,most of them have intact tympanic cover.Postauricular abscess incision and complete wall mastidectomy and upper tympanectomy are performed in children with more severe symptoms,while conservative treatment can be used in children with milder symptom.
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