Preadmission myringotomy had been performed in 7 patients, all of whom underwent mastoidectomy for a subperiosteal abscess.
7%) had been performed on patients with a clinical subperiosteal abscess in the mastoid region, 14 (26.
Of the 14 mastoidectomies that had been performed because conservative treatment had failed, 4 were performed between 24 and 48 hours after admission; a subperiosteal abscess was found in 3 of these cases, one of which had been underdiagnosed on computed tomography (CT).
CT overdiagnosed sigmoid sinus thrombosis in 1 case and mastoid cortex erosion in 2 cases--1 child with a subperiosteal abscess and 1 child with meningitis.
In 3 of these cases, Streptococcus pyogenes had been isolated from the aural discharge, but Staphylococcus aureus was found in the subperiosteal abscess.
9%), purulent discharge was obtained from a subperiosteal abscess, mastoid cavity, or intracranial collection.
Mastoidectomy with a single antibiotic was effective in all 29 cases of clinical subperiosteal abscess.
In another patient, recurrent subperiosteal abscess developed 10 months postoperatively; that cholesteatoma was discovered during revision surgery to remove the abscess.
3-12) In cases of complicated acute otomastoiditis, we believe that the true pathogens can be found only in the subperiosteal abscess, the mastoid cavity, or the intracranial collection.
Sex and type of treatment Medical Endoscopic Open surgical Infection M F management surgery procedure Periorbital cellulitis 15 6 All 0 0 (n = 21) Orbital cellulitis 4 2 All 0 0 (n = 6) Subperiosteal abscess * 9 2 All 7 5 (n = 12) Orbital abscess 5 0 All 0 5 (n =5) * One of these patients also had a supraorbital abscess.
Selective non-surgical management of subperiosteal abscess of the orbit: Computerized tomography and clinical course as indication for surgical drainage.