Evaluating the Sequelae of Mastoidectomy for Acute Mastoiditis: A Long Term Follow-Up Study of Mastoid Function

Background: Despite the widespread use of antibiotics, acute mastoiditis (AM) and re-lated complications resulting from acute purulent otitis media continue to occur, pre-dominantly in children. Although numerous studies have focused on the pathogenesis, aetiological agents, and treatment of AM, comprehensive investigations of the long-term outcomes of AM and the physiological consequences of surgical intervention in the temporal bone are lacking. Methods: A cohort of patients who had undergone mastoidectomy for AM were invited for evaluation at least five years postoperatively. The assessment included the COMQ-12 questionnaire, clinical examination and otomicroscopy, extended high-frequency pure-tone audiometry, DPOAE, middle ear impedance testing, and a newly developed protocol for non-invasive mastoid function measurement. Results were compared with a control group and a group treated solely with tympanostomy for acute otitis media at risk of mastoiditis. Results: In the COMQ-12 questionnaire, we found that patients who underwent mas-toidectomy experienced slightly greater difficulties with hearing in quiet environments and in noisy settings, as well as an increased perception of tinnitus and an unpleasant sensation around the ear. Otomicroscopy revealed minor structural changes in the test groups, whereas no such changes were observed in the control group. Pure-tone au-diometry demonstrated approximately 10 dB higher threshold values at high and ex-tended high frequencies, similar to findings in the DPOAE test. Middle ear impedance testing indicated an elevation in the stapedius reflex threshold, while other tests did not reveal statistically significant differences. Mastoid function testing in patients who had undergone mastoidectomy showed preserved pressure buffer function but a reduced capacity for thermal insulation of the vestibular organ under extreme thermal stimula-tion—an occurrence that is rarely encountered in daily life. Conclusions: In the long term, most patients recovering from AM exhibit only minor functional and structural sequelae. In the context of AM management, the effects of mastoidectomy are negligible compared to those of less invasive surgical interventions.