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Head and Neck
Diagnosis
Temporal Bone
Middle Ear-Mastoid
Infectious and Inflammatory Lesions
Coalescent Otomastoiditis With Complications
Coalescent Otomastoiditis With Complications
William T. O'Brien, Sr., DO, FAOCR; Caroline D. Robson, MBChB; H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Acute coalescent otomastoiditis (ACOM)
              • Acute otomastoiditis (AOM)

            • Synonyms

              • Coalescent otomastoiditis with abscess

            • Definitions

              • ACOM: Acute middle ear-mastoid (ME-M) infection with progressive bony resorption and demineralization due to intramastoid empyema ± osteomyelitis
              • ACOM + abscess: Coalescent otomastoiditis with resultant intracranial or extracranial abscess
              • AOM: Acute infection in ME-M without destruction of mastoid septations or cortex

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Saat R et al: Detection of coalescent acute mastoiditis on MRI in comparison with CT. Clin Neuroradiol. ePub, 2020
                                        2. Saat R et al: Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images. Eur Radiol. 26(8):2632-9, 2016
                                        3. Saat R et al: MR imaging features of acute mastoiditis and their clinical relevance. AJNR Am J Neuroradiol. 36(2):361-7, 2015
                                        4. Funamura JL et al: Otogenic lateral sinus thrombosis: case series and controversies. Int J Pediatr Otorhinolaryngol. 78(5):866-70, 2014
                                        5. Psarommatis IM et al: Algorithmic management of pediatric acute mastoiditis. Int J Pediatr Otorhinolaryngol. 76(6):791-6, 2012
                                        6. Osborn AJ et al: Decisions regarding intracranial complications from acute mastoiditis in children. Curr Opin Otolaryngol Head Neck Surg. 19(6):478-85, 2011
                                        7. Zevallos JP et al: Advanced pediatric mastoiditis with and without intracranial complications. Laryngoscope. 119(8):1610-5, 2009
                                        8. Park H et al: Surgical management of acute mastoiditis with epidural abscess. Acta Otolaryngol. 126(7):782-4, 2006
                                        9. Taylor MF et al: Indications for mastoidectomy in acute mastoiditis in children. Ann Otol Rhinol Laryngol. 113(1):69-72, 2004
                                        10. Khan I et al: Mastoiditis in children. J Laryngol Otol. 117(3):177-81, 2003
                                        11. Migirov L: Computed tomographic versus surgical findings in complicated acute otomastoiditis. Ann Otol Rhinol Laryngol. 112(8):675-7, 2003
                                        12. Vazquez E et al: Imaging of complications of acute mastoiditis in children. Radiographics. 23(2):359-72, 2003
                                        13. Bauer PW et al: Mastoid subperiosteal abscess management in children. Int J Pediatr Otorhinolaryngol. 63(3):185-8, 2002
                                        14. Tarantino V et al: Acute mastoiditis: a 10 year retrospective study. Int J Pediatr Otorhinolaryngol. 66(2):143-8, 2002
                                        15. Dobben GD et al: Otogenic intracranial inflammations: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2):76-86, 2000
                                        16. Dhooge IJ et al: Value of computed tomography of the temporal bone in acute otomastoiditis. Rev Laryngol Otol Rhinol (Bord). 119(2):91-4, 1998
                                        17. Spiegel JH et al: Contemporary presentation and management of a spectrum of mastoid abscesses. Laryngoscope. 108(6):822-8, 1998
                                        18. Mafee MF et al: Acute otomastoiditis and its complications: role of CT. Radiology. 155(2):391-7, 1985
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Acute coalescent otomastoiditis (ACOM)
                                                    • Acute otomastoiditis (AOM)

                                                  • Synonyms

                                                    • Coalescent otomastoiditis with abscess

                                                  • Definitions

                                                    • ACOM: Acute middle ear-mastoid (ME-M) infection with progressive bony resorption and demineralization due to intramastoid empyema ± osteomyelitis
                                                    • ACOM + abscess: Coalescent otomastoiditis with resultant intracranial or extracranial abscess
                                                    • AOM: Acute infection in ME-M without destruction of mastoid septations or cortex

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Saat R et al: Detection of coalescent acute mastoiditis on MRI in comparison with CT. Clin Neuroradiol. ePub, 2020
                                                                              2. Saat R et al: Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images. Eur Radiol. 26(8):2632-9, 2016
                                                                              3. Saat R et al: MR imaging features of acute mastoiditis and their clinical relevance. AJNR Am J Neuroradiol. 36(2):361-7, 2015
                                                                              4. Funamura JL et al: Otogenic lateral sinus thrombosis: case series and controversies. Int J Pediatr Otorhinolaryngol. 78(5):866-70, 2014
                                                                              5. Psarommatis IM et al: Algorithmic management of pediatric acute mastoiditis. Int J Pediatr Otorhinolaryngol. 76(6):791-6, 2012
                                                                              6. Osborn AJ et al: Decisions regarding intracranial complications from acute mastoiditis in children. Curr Opin Otolaryngol Head Neck Surg. 19(6):478-85, 2011
                                                                              7. Zevallos JP et al: Advanced pediatric mastoiditis with and without intracranial complications. Laryngoscope. 119(8):1610-5, 2009
                                                                              8. Park H et al: Surgical management of acute mastoiditis with epidural abscess. Acta Otolaryngol. 126(7):782-4, 2006
                                                                              9. Taylor MF et al: Indications for mastoidectomy in acute mastoiditis in children. Ann Otol Rhinol Laryngol. 113(1):69-72, 2004
                                                                              10. Khan I et al: Mastoiditis in children. J Laryngol Otol. 117(3):177-81, 2003
                                                                              11. Migirov L: Computed tomographic versus surgical findings in complicated acute otomastoiditis. Ann Otol Rhinol Laryngol. 112(8):675-7, 2003
                                                                              12. Vazquez E et al: Imaging of complications of acute mastoiditis in children. Radiographics. 23(2):359-72, 2003
                                                                              13. Bauer PW et al: Mastoid subperiosteal abscess management in children. Int J Pediatr Otorhinolaryngol. 63(3):185-8, 2002
                                                                              14. Tarantino V et al: Acute mastoiditis: a 10 year retrospective study. Int J Pediatr Otorhinolaryngol. 66(2):143-8, 2002
                                                                              15. Dobben GD et al: Otogenic intracranial inflammations: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2):76-86, 2000
                                                                              16. Dhooge IJ et al: Value of computed tomography of the temporal bone in acute otomastoiditis. Rev Laryngol Otol Rhinol (Bord). 119(2):91-4, 1998
                                                                              17. Spiegel JH et al: Contemporary presentation and management of a spectrum of mastoid abscesses. Laryngoscope. 108(6):822-8, 1998
                                                                              18. Mafee MF et al: Acute otomastoiditis and its complications: role of CT. Radiology. 155(2):391-7, 1985