Acute coalescent mastoiditis.

A retrospective review of 11 cases of acute coalescent mastoiditis from 1974 to 1979 is presented. The common historical data include the recent onset of purulent otitis media, which was often incompletely treated with antibiotics, and fever, lethargy, and irritability. The eardrums were red, bulging, and usually intact. A postauricular abscess was present, and the affected ear protruded downward and outward. The mastoid radiographs invariably showed cloudiness and dissolution of the air cell septations. Initial therapy included paracentesis for culture and sensitivity, and initiation of parenteral antibiotics. Surgical therapy consisted of wide myringotomy, drainage of the postauricular abscess, and complete mastoidectomy. Hearing was normal postoperatively in all cases.