Increased cases of otogenic complications in children in winter at a large university hospital

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Introduction In December 2022, the WHO described an increase in invasive Group A Streptococcus infections in children in the European region, sometimes with fatal outcomes. During the Covid-19 pandemic, there were significantly fewer adenotomies performed on children because of limited surgical capacity. The aim of the study was to investigate a possible correlation between the increased incidence of otogenic complications and adenotomies that were not performed. Material and methods We carried out an OPS enquiry on mastoidectomy at our clinic in the period from 01/2017 to 05/2023 and set the upper age limit at the time of surgery at 11 years. We analysed the individual cases, excluded cases in which mastoidectomies were conducted as part of elective surgery and compared the frequencies by t-testing. Results From 2017 until the start of Covid-19-related contact restrictions in spring 2020, we performed 0.6 (15 f, 8 m) emergency mastoidectomies per month in under-12-year-olds. During the years with less infections 04/2020 to 05/2022, the rate was less than 0.1 per month. In the period from 06/2022 to 05/2023, the rate increased significantly to 2.2 (6 f, 20 m) per month (p=0.013). 3 out of 26 patients described otitis symptoms that had already been present for more than four weeks prior to hospital admission; two further patients had already undergone an adenotomy. Conclusion We found a significant increase in otogenic and partly intracranial complications after otitis in children in the 2022/2023 period. There was no increase in cases in which an elective adenotomy would have been indicated due to chronic problems in advance. Therefore, we do not assume a correlation between the increase in cases and the limited surgical capacities due to the Covid-19 pandemic. Publication History Article published online: 19 April 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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