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Pediatric Otolaryngology

(512) Trends in Pediatric Mastoiditis and Its Complications: A Retrospective Review

Monday, October 2, 2023
2:45 PM - 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Kaveri Curlin, BS

    Medical Student
    University of California, Irvine School of Medicine
    Claremont, California, United States

    • Senior Author(s)

  • Jay Bhatt, M.D, FAAP

    Pediatric Otolaryngology
    Children's Hospital of Orange County
    Orange, California, United States

    • Co-Author(s)

  • Benjamin F. Bitner, MD

    Resident Physician
    University of California, Irvine Department of Otolaryngology
    Irvine, California, United States

  • KG

    Khodayar Goshtasbi, MD, MS

    University of California, Irvine, USA

Disclosure(s):
Kaveri Curlin, BS: No relevant relationships to disclose.
Jay Bhatt, M.D, FAAP: No relevant relationships to disclose.
Benjamin F. Bitner, MD: No relevant relationships to disclose.


Introduction: Mastoiditis is a serious, potentially devastating complication of acute otitis media that may lead to further intracranial complications if left untreated. The purpose of this study is to analyze trends in patient demographics, trends, and costs of pediatric mastoiditis to identify areas for improvement in the management of this condition.

Methods: The 2016-2022 Pediatric Health Information System database was queried for patients diagnosed with mastoiditis including otitis media, acute mastoiditis, subperiosteal abscess of mastoid, and chronic mastoiditis. Patient demographics, length of stay, duration of inpatient IV antibiotic treatment, billed charges and estimated costs were analyzed.

Results: A total of 838 patients (42.00% female) less than 18 years of age were diagnosed with either acute mastoiditis, subperiosteal abscess of the mastoid, chronic mastoiditis, otitis media, or petrositis. There was a significant difference in mean age at presentation, with subperiosteal abscess being the youngest, and chronic mastoiditis the oldest (4.85±4.41 vs 10.16±4.48 years, p< 0.001). Males made up a greater proportion of diagnosed cases of all pathologies queried, except petrositis. There was no racial difference among diagnoses (p=0.39). There was a significant difference in mean estimated cost, with petrositis being the highest and otitis media the lowest (US $43,088.75± 26735.83 vs $5,521.96±7391.95, p< 0.001). Otitis media also had the lowest mean length of stay in days, whereas acute mastoiditis had the highest (1.23±1.25 vs 6.30±5.93, p< 0.001). Similarly, acute mastoiditis has the highest mean days of IV antibiotic while otitis media had the lowest number (5.84±5.88 vs 0.19± 1.08, p< 0.001).

Conclusions: There were notable, clinically, and statistically significant differences in age at presentation, gender, cost of hospital stay, and days of IV antibiotic usage among US children diagnosed with severe acute otitis media, mastoiditis, and its complications. Opportunities to reduce cost and length of stay can be explored based on the above trends.