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Acute mastoiditis is a common presentation in the paediatric population across ENT services worldwide. An initial expectation of a rise in the numbers of acute mastoiditis associated with the initial findings of SARS-CoV-2 (COVID-19) virus presence in middle ear in 2020, was met with reports of reduction on the incidence of acute mastoiditis across the globe. Anticipating a shift in the pathophysiology and management of acute otitis media (AOM), this study aims to investigate the impact of COVID-19 on the management and outcomes of paediatric mastoiditis in the UK. Forty-eight sites across the UK participated in the current study, comparing their attendances and admissions between the years 2019-2020 and 2020-2021. Remarkably, no peak incidence was observed during the COVID pandemic, which was noted in the previous year raising to 9.4 admissions per week during wintertime. Microbiology cultures showed an increased incidence of Pseudomonas infection during the period of the COVID pandemic; almost half of the patients underwent an invasive procedure prior to the pandemic, whereas only a quarter did during the pandemic, with no notable complication rate or requirement for prolonged hospital stay compared to the previous, more invasive approach. This audit aspires to document the experience in managing otomastoiditis across different centres in the UK. Although there are some limitations due to the heterogeneous population and variations in local practices, it reflects excellently the shift in the management of the pathology that was experienced throughout the pandemic. In terms of future implications, this might be an opportunity to start designing larger cohort studies to ascertain the timing and the role of surgical intervention in the treatment of mastoiditis.

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study.
Smith M, Jones H, Hardman J, et al.
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Dimitrios Spinos

NHS West Midlands, UK.

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