Mastoiditis is the bacterial infection of the mastoid air cells of the skull behind the ear. The mastoid air cells protect the delicate structures of the ear, regulate ear pressure and protect the temporal bone during trauma. Mastoiditis is often developed as a result of middle ear infections.
The mastoid bone is the portion of the temporal bone of the skull that is present behind the ear consisting of open, air-containing spaces. As many essential structures pass through the mastoid bone, infection of mastoid may spread outside of the mastoid bone and cause serious health complications. Mastoiditis is most common in children and also may occur in adults.
The most common cause of mastoiditis is the middle ear infection which is left untreated. This can spread to the inner ear, attacking the sacs of the mastoid bone and may cause the mastoid bone to begin to disintegrate. Sometimes, cholesteatoma can also cause mastoiditis. Cholesteatoma is an abnormal growing collection of skin cells in the middle part of the ear, behind the ear drum, that can prevent the ear from draining, which can lead to mastoiditis.
Mastoiditis is represented by the following symptoms:
Any ear pain with fever or posterior ear tenderness, redness or swelling should be evaluated by an ENT specialist. Clinical diagnosis of mastoiditis includes reviewing the medical history of the patient for ear infections, symptoms like headaches and ear discharge, an initial ear examination to look for redness, tenderness and swelling behind the ear to evaluate the ear's function and check for any inflammation.
If the infection is suspected, you may be recommended for further tests to confirm the diagnosis, which may include x-rays, blood tests and swabbed ear-fluid cultures. Blood tests include leukocytes count or erythrocyte sedimentation rate (ESR).
Excessive leukocytes and elevation of erythrocyte sedimentation rate (ESR) indicates the confirmation of mastoiditis. In case of severe infections CT or MRI scan are suggested. CT and MRI scan help in revealing the opacity of the mastoid air cells.
The mastoid air cells appear clear when there is no infection. Presence of fluid in mastoid air cells can also be diagnosed by using MRI scan. Culture tests of the ear discharge may reveal the type of bacteria present.
Untreated mastoiditis may cause many complications which include:
Once mastoiditis is diagnosed, your ENT Specialist may prescribe oral antibiotics, eardrops or regular cleaning of the ear. In cases of acute mastoiditis, treatment may take place in your local hospital, where antibiotics will be administered by an IV drip. Surgery is also an option for the treatment of mastoiditis.
Myringotomy helps drain the fluid from the middle ear. A small hole is made in the eardrum to drain the fluid and relieve pressure from the middle ear. A small tube may be inserted into the middle ear to keep the hole from closing so as to allow for continued drainage. Usually, the tube will fall out on its own after 6 to 12 months. In cases of severe infection, infected mastoid bone is removed called mastoidectomy.
Prevention is always better than cure. Take preventive measures such as not leaving any of the head and neck infections untreated. Avoid swimming pools that are not cleaned regularly, and avoid water retention in the ear canal.
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