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Mastoiditis

 

Mastoiditis is an infection of the mastoid bone of the skull. The mastoid is located just behind the ear.

Causes

Mastoiditis is most often caused by a middle ear infection (acute otitis media). The infection may spread from the ear to the mastoid bone. The bone has a honeycomb-like structure that fills with infected material and may break down.

The condition is most common in children. Before antibiotics, mastoiditis was one of the leading causes of death in children. The condition does not occur very often today. It is also much less dangerous.

Symptoms

 

Symptoms include:

  • Drainage from the ear
  • Ear pain or discomfort
  • Fever, may be high or suddenly increase
  • Headache
  • Hearing loss
  • Redness of the ear or behind the ear
  • Swelling behind ear, may cause ear to stick out

 

Exams and Tests

 

An exam of the head may reveal signs of mastoiditis. The following tests may show an abnormality of the mastoid bone:

  • CT scan of the ear
  • Head CT scan

A culture of drainage from the ear may show bacteria.

 

Treatment

 

Mastoiditis may be hard to treat because the medicine may not reach deeply into the bone. The condition sometimes requires repeated or long-term treatment. The infection is treated with antibiotic injections, followed by antibiotics taken by mouth.

Surgery to remove part of the bone and drain the mastoid (mastoidectomy) may be needed if antibiotic treatment does not work. Surgery to drain the middle ear through the eardrum (myringotomy) may be needed to treat the middle ear infection.

 

Outlook (Prognosis)

 

Mastoiditis can be cured. However, it may be hard to treat and may come back.

 

Possible Complications

 

Complications may include:

  • Destruction of the mastoid bone
  • Dizziness or vertigo
  • Epidural abscess
  • Facial paralysis
  • Meningitis
  • Partial or complete hearing loss
  • Spread of infection to the brain or throughout the body

 

When to Contact a Medical Professional

 

Call your health care provider if you have symptoms of mastoiditis.

Also call if:

  • You have an ear infection that does not respond to treatment or is followed by new symptoms.
  • Your symptoms do not respond to treatment.

 

Prevention

 

Prompt and thorough treatment of ear infections reduces the risk for mastoiditis.

 

 

References

Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 139.

Klein JO. Otitis externa, otitis media, and mastoiditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 62.

O'Handley JG, Tobin EJ, Shah AR. Otorhinolaryngology. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 18.

 
  • Mastoiditis - side view of head

    Mastoiditis - side view of head - illustration

    Mastoiditis is an infection of the bony air cells in the mastoid bone, located just behind the ear. It is rarely seen today because of the use of antibiotics to treat ear infections. This child has drainage from the ear and redness (erythema) behind the ear over the mastoid bone.

    Mastoiditis - side view of head

    illustration

  • Mastoiditis - redness and swelling behind ear

    Mastoiditis - redness and swelling behind ear - illustration

    Mastoiditis is an infection of the bony air cells in the mastoid bone, located just behind the ear. It is rarely seen today because of the use of antibiotics to treat ear infections. This child has noticeable swelling and redness behind his right ear because of mastoiditis.

    Mastoiditis - redness and swelling behind ear

    illustration

  • Mastoidectomy  - series

    Mastoidectomy - series

    Presentation

    • Mastoiditis - side view of head

      Mastoiditis - side view of head - illustration

      Mastoiditis is an infection of the bony air cells in the mastoid bone, located just behind the ear. It is rarely seen today because of the use of antibiotics to treat ear infections. This child has drainage from the ear and redness (erythema) behind the ear over the mastoid bone.

      Mastoiditis - side view of head

      illustration

    • Mastoiditis - redness and swelling behind ear

      Mastoiditis - redness and swelling behind ear - illustration

      Mastoiditis is an infection of the bony air cells in the mastoid bone, located just behind the ear. It is rarely seen today because of the use of antibiotics to treat ear infections. This child has noticeable swelling and redness behind his right ear because of mastoiditis.

      Mastoiditis - redness and swelling behind ear

      illustration

    • Mastoidectomy - series

      Presentation

    Tests for Mastoiditis

     

       

      Review Date: 5/25/2016

      Reviewed By: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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