{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:28:11Z","timestamp":1783074491923,"version":"3.54.6"},"reference-count":59,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T00:00:00Z","timestamp":1538611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>There is no standard of care for treatment of pediatric acute mastoiditis (PAM). We systematically reviewed the English literature to evaluate the efficacy of PAM treatment options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Embase, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library were searched from inception to January 2016, along with manual bibliography searches, for studies describing surgical or medical therapy. Two independent evaluators reviewed each abstract and article.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 310 articles, and 55 met inclusion criteria. Thirty\u2010three evaluated surgical options and included 2,930 patients (mean age = 2.8 years) including those with myringotomy \u00b1 tube placement (n = 920); 140 needed additional surgery, drainage of subperisoteal abscess (SPA) (n = 142) \u00b1 myringotomy or tube placement, 29 patients needed additional surgery and mastoidectomy \u00b1 myringotomy or tube placement (n = 612), with 611 reporting resolution. Using a random effects model, the estimated success probability with 95% confidence intervals (CI) are myringotomy \u00b1 tube placement 94% (95% CI: 84.5%\u201097.8%), and drainage of subperiosteal abscess with concurrent myringotomy \u00b1 tube placement was 86.5% (95% CI: 66.4%\u201095.4%). Using a random effects model, mastoidectomy success was 99.7% (95% CI: 77.5%\u2010100%). Nineteen studies evaluated medical therapy (n = 990 patients). The average cure rate was 71.7% (median = 70%; range, 26.3%\u2013100%), and estimated success was 72.9% (95% CI: 60.5%\u201082.5%) by meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Myringotomy with or without tube placement and mastoidectomy have the highest cure rates for PAM. With SPA, incision and drainage with myringotomy with or without tube can be considered. Medical treatment cured nearly 72% of children. Ultimately, management should be based on surgeons' experience and judgment, patient characteristics, and severity of disease. <jats:italic>Laryngoscope<\/jats:italic>, 129:754\u2013760, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27462","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T19:45:12Z","timestamp":1538768712000},"page":"754-760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Medical Versus Surgical Treatment of Pediatric Acute Mastoiditis: A Systematic Review"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-6206","authenticated-orcid":false,"given":"Samantha","family":"Anne","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Cleveland Clinic  Cleveland 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