RESUMO
To discuss the optimal diagnosis and treatment strategy for acute mastoiditis. Retrospective review of 12 patients with mastoiditis [6 males, 6 females] aged 12 to 20 years who were treated at our military hospitals from 1996 through 2001. Three diagnostic criteria were used to identify acute mastoiditis. Among our patients the most common abnormal findings on physical examination was an abnormal tympanic membrane, which was observed in the 12 patients. The second most common finding was swelling and erythema in the postauricular area. Radiological examination showed abnormal pneumatization of 8 of them. Eight of our patients were cured within 3 weeks by intravenous antibiotics, two of them underwent myringotomy. Surgery was performed on the 4 patients who did not respond to medical treatment. Our experience suggests that an accurate early diagnosis and appropriate antibiotic therapy are usually sufficient to cure acute mastoiditis. When the inflammation does not respond to medical treatment, the physician should suspect that the infection might be caused by antibiotic tolerant organisms or a typical pathogen. If complications ensue, we believe it is best to carry out surgical treatment as soon as possible