(A904) Acute Mastoiditis Treatment Before and After COVID-19

Introduction: To determine whether surgical intervention for acute mastoiditis has changed since the COVID-19 pandemic.

Methods: Two cohorts were created using data from TriNetX. Both cohorts included children, birth to 18 years of age with acute mastoiditis. Children with neoplasm of the acoustic nerve, cholesteatoma, chronic mastoiditis, neurofibromatosis type 2 or neoplasms of cranial nerves were excluded. For the post-pandemic group, any patient with SARS-CoV-2 prior to acute mastoiditis was also excluded. Acute mastoiditis was set as an index event and outcomes of tympanostomy under general anesthesia and mastoidectomy were evaluated within 90 days of acute mastoiditis diagnosis. To balance each cohort, propensity score matching was performed using age, sex, race/ethnicity, and relevant comorbidities.

Results: Each cohort consisted of 1,557 patients, after matching. Age at time of diagnosis was 4.66 ± 3.49 for Cohort 1 and 4.67 ± 3.62 for Cohort 2. For acute mastoiditis treated with tympanostomy, risk in Cohort 1 was 10.148% and 15.543% in Cohort 2. The data shows that the use of tympanostomy was increased for treatment of acute mastoiditis following the COVID-19 pandemic (p < 0.0001). For acute mastoiditis treated with mastoidectomy, risk in Cohort 1 was 2.184% and 4.046% in Cohort 2. The data also shows that the use of mastoidectomy was increased for treating acute mastoiditis following the COVID-19 pandemic (p 0.0028).

Conclusions: Since the COVID-19 pandemic, surgical intervention for acute mastoiditis has increased in frequency, possibly signaling more severe disease in the pediatric population.