Mastoiditis is an inflammation within the mastoid portion of the temporal bone. The temporal bone forms the side of the skull, and its temporal portion is that part immediately behind the ear. Mastoiditis is usually caused by an infection.
Inflammation that starts in the mastoid itself is quite rare. Mastoiditis is almost always caused by an infection in the middle ear, which is behind the eardrum. Because the mastoid is close to the middle ear, it is easy for middle ear infections, such as acute otitis media, to spread to the mastoid.
Long-lasting (chronic) mastoiditis lasts for more than 3 months. Acute or shorter-lasting mastoiditis lasts less than 3 weeks.
Signs of mastoiditis may include: feverpain behind the earinfected drainage coming through a hole in the eardruma red and swollen lining of the middle earsome degree of hearing impairment
Other signs are usually only seen with acute mastoiditis. These may include: swelling and redness of the skin behind the earsignificant swelling behind the ear that causes the ear to be pushed forwarda soft, compressible feeling to the bone behind the ear. This means that there is an abscess, a pocket of pus, under the skin.
Chronic mastoiditis does not produce changes over the bone behind the ear. Most of the time, a person with chronic mastoiditis has no symptoms other than occasional pain. When the condition flares up, pus can drain from the ear canal.
The main cause of acute mastoiditis is untreated or incompletely treated middle ear infection (acute otitis media). The main cause of chronic mastoiditis is a perforated eardrum combined with a long-lasting infection in the middle ear, known as chronic otitis media.
Benign ear growths, particularly cysts known as cholesteatomas, are also frequent causes.
Antibiotics for ear infections and methods to drain fluid from the ears can help prevent most cases of mastoiditis. It is important that a person take the full course of the antibiotic to prevent mastoiditis. Also, children who have frequent infections should be monitored in an effort to prevent mastoiditis and ear cysts from developing.
To make the diagnosis, the healthcare professional first examine the person's ear with an otoscope. The professional may then order x-ray tests or a CT scan.
If the infection is severe, the x-ray tests will show damage or infection of the bone. A CT will demonstrate similar changes but gives a more complete picture of the anatomy of the bone and other middle ear structures.
Acute mastoiditis can be complicated by: material under the skin behind the earfacial paralysisnerve deafness or hearing impairmentvertigo or dizzinessmeningitis, or inflammation of the lining of the brain, which may cause permanent brain damage or deatha blood clot in the veins that drain the blood from the brainan abscess or pocket of pus under the skin, in nearby muscles, or even in the brain. A brain abscess can result in permanent brain damage or death.scarring in the ear or mastoid
There are no risks to others, as the condition is not contagious.
Treatment for acute mastoiditis includes the insertion of an ear tube through the eardrum to allow drainage of infected fluid. A cut can also be made in the eardrum for the same purpose. If there is a collection of pus under the skin behind the ear, it may need to be drained.
The first step in treating chronic mastoiditis is oral or topical antibiotics. If these do not clear up the problem, surgery is needed to remove the diseased part of the mastoid and repair the eardrum. If an ear cyst exists, the cyst is removed and the eardrum repaired. If the bones of the middle ear have been damaged, they will be repaired as well.
Placement of the drainage tubes can result in complications such as long-lasting holes in the eardrum, ear drainage, and rarely, deafness. Side effects from surgery to remove the mastoid can include damage to nearby structures such as: facial paralysis from injury to the facial nervehearing impairment from damage to the bones or nerves in the ear that aid in hearingvertigo from damage to the ear's balance system
Most cases of acute mastoiditis clear up once the ear tube is inserted and antibiotics are started. The tube is left in until it falls out by itself, usually within 6 to 12 months. If surgery for chronic mastoiditis is successful, the hole in the eardrum will heal closed. The person's hearing will improve, though it may not completely return to normal in some cases. The ear will stop draining.
An new or worsening symptoms should be reported to the healthcare professional.