RESUMO
Thirty six cases of acute mastoiditis were treated to Federal Government Services Hospital, Islamabad over a period of 11 years [from 1986- up to 1997]. The salient features in these cases was presence of extensive Cholesteatoma in the middle ear cleft. The affected children belonged to poor communities, they were malnourished and attended hospital in a state of emergency. The presentation and course of the disease confirms the aggressive and potentially serious nature of the pathology, requiring early attention, in order to avert impending complications. Significantly all patients had a history of ear discharge prior to abscess formation. It appears that in our environment, most mastoiditis with abscess formation develop from chronic otitis media with Cholesteatoma