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Coalescent Otomastoiditis
H. Ric Harnsberger, MD; Caroline D. Robson, MBChB
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Acute coalescent otomastoiditis (ACOM)
              • Acute otomastoiditis or acute otitis media (AOM)
            • Synonyms

              • Erosive otomastoiditis, coalescent otomastoiditis
            • Definitions

              • Acute infection of middle ear-mastoid (ME-M) air cells with progressive resorption & demineralization of mastoid septae ± mastoid cortex
                • Most pronounced when intramastoid empyema and mastoid osteomyelitis are present

            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. Redaelli de Zinis LO et al: Internal jugular vein thrombosis associated with acute mastoiditis in a pediatric age. Otol Neurotol. 27(7):937-44, 2006
                                        2. Zanetti D et al: Indications for surgery in acute mastoiditis and their complications in children. Int J Pediatr Otorhinolaryngol. 70(7):1175-82, 2006
                                        3. Migirov L et al: Mastoidectomy for acute otomastoiditis: our experience. Ear Nose Throat J. 84(4):219-22, 2005
                                        4. Agarwal A et al: Natural history of sigmoid sinus thrombosis. Ann Otol Rhinol Laryngol. 112(2):191-4, 2003
                                        5. Migirov L: Computed tomographic versus surgical findings in complicated acute otomastoiditis. Ann Otol Rhinol Laryngol. 112(8):675-7, 2003
                                        6. Vazquez E et al: Imaging of complications of acute mastoiditis in children. Radiographics. 23(2):359-72, 2003
                                        7. Matsubara K et al: Acute coalescent mastoiditis and acoustic sequelae in an infant with severe congenital neutropenia. Int J Pediatr Otorhinolaryngol. 62(1):63-7, 2002
                                        8. Tarantino V et al: Acute mastoiditis: a 10 year retrospective study. Int J Pediatr Otorhinolaryngol. 66(2):143-8, 2002
                                        9. Zapalac JS et al: Suppurative complications of acute otitis media in the era of antibiotic resistance. Arch Otolaryngol Head Neck Surg. 128(6):660-3, 2002
                                        10. Maroldi R et al: Computed tomography and magnetic resonance imaging of pathologic conditions of the middle ear. Eur J Radiol. 40(2):78-93, 2001
                                        11. Dobben GD et al: Otogenic intracranial inflammations: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2):76-86, 2000
                                        12. Go C et al: Intracranial complications of acute mastoiditis. Int J Pediatr Otorhinolaryngol. 52(2):143-8, 2000
                                        13. Antonelli PJ et al: Computed tomography and the diagnosis of coalescent mastoiditis. Otolaryngol Head Neck Surg. 120(3):350-4, 1999
                                        14. Kaplan DM et al: Otogenic lateral sinus thrombosis in children. Int J Pediatr Otorhinolaryngol. 49(3):177-83, 1999
                                        15. Castillo M et al: Imaging of Bezold's abscess. AJR Am J Roentgenol. 171(6):1491-5, 1998
                                        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
                                        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 or acute otitis media (AOM)
                                                  • Synonyms

                                                    • Erosive otomastoiditis, coalescent otomastoiditis
                                                  • Definitions

                                                    • Acute infection of middle ear-mastoid (ME-M) air cells with progressive resorption & demineralization of mastoid septae ± mastoid cortex
                                                      • Most pronounced when intramastoid empyema and mastoid osteomyelitis are present

                                                  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. Redaelli de Zinis LO et al: Internal jugular vein thrombosis associated with acute mastoiditis in a pediatric age. Otol Neurotol. 27(7):937-44, 2006
                                                                              2. Zanetti D et al: Indications for surgery in acute mastoiditis and their complications in children. Int J Pediatr Otorhinolaryngol. 70(7):1175-82, 2006
                                                                              3. Migirov L et al: Mastoidectomy for acute otomastoiditis: our experience. Ear Nose Throat J. 84(4):219-22, 2005
                                                                              4. Agarwal A et al: Natural history of sigmoid sinus thrombosis. Ann Otol Rhinol Laryngol. 112(2):191-4, 2003
                                                                              5. Migirov L: Computed tomographic versus surgical findings in complicated acute otomastoiditis. Ann Otol Rhinol Laryngol. 112(8):675-7, 2003
                                                                              6. Vazquez E et al: Imaging of complications of acute mastoiditis in children. Radiographics. 23(2):359-72, 2003
                                                                              7. Matsubara K et al: Acute coalescent mastoiditis and acoustic sequelae in an infant with severe congenital neutropenia. Int J Pediatr Otorhinolaryngol. 62(1):63-7, 2002
                                                                              8. Tarantino V et al: Acute mastoiditis: a 10 year retrospective study. Int J Pediatr Otorhinolaryngol. 66(2):143-8, 2002
                                                                              9. Zapalac JS et al: Suppurative complications of acute otitis media in the era of antibiotic resistance. Arch Otolaryngol Head Neck Surg. 128(6):660-3, 2002
                                                                              10. Maroldi R et al: Computed tomography and magnetic resonance imaging of pathologic conditions of the middle ear. Eur J Radiol. 40(2):78-93, 2001
                                                                              11. Dobben GD et al: Otogenic intracranial inflammations: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2):76-86, 2000
                                                                              12. Go C et al: Intracranial complications of acute mastoiditis. Int J Pediatr Otorhinolaryngol. 52(2):143-8, 2000
                                                                              13. Antonelli PJ et al: Computed tomography and the diagnosis of coalescent mastoiditis. Otolaryngol Head Neck Surg. 120(3):350-4, 1999
                                                                              14. Kaplan DM et al: Otogenic lateral sinus thrombosis in children. Int J Pediatr Otorhinolaryngol. 49(3):177-83, 1999
                                                                              15. Castillo M et al: Imaging of Bezold's abscess. AJR Am J Roentgenol. 171(6):1491-5, 1998
                                                                              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