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Mastoiditis

Mastoiditis is a bacterial infection of the mastoid bone. The mastoid bone, which sits behind the ear, consists of air spaces that help drain the middle ear.

When the mastoid cells become infected or inflamed, often as a result of an unresolved middle ear infection (otitis media), mastoiditis can develop. In acute mastoiditis, infection may spread outside of the mastoid bone and cause serious health complications.

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Mastoiditis typically affects children, but adults can also be affected.

Some people have chronic mastoiditis, an ongoing infection of the middle ear and mastoid causing persistent drainage from the ear.

Mastoiditis Causes

As mentioned above, mastoiditis often develops as a result of a middle ear infection. Bacteria from the middle ear can travel into the air cells of the mastoid bone. In addition, a skin cyst (cholesteatoma) in the middle ear may block drainage of the ear, leading to mastoiditis.

Mastoiditis Symptoms

Mastoiditis symptoms may include:

  • Fever, irritability, and lethargy
  • Swelling of the ear lobe
  • Redness and tenderness behind the ear
  • Drainage from the ear
  • Bulging and drooping of the ear (in acute mastoiditis)

 

Mastoiditis Diagnosis

Any unusual ear or fever symptoms should be evaluated by a doctor. The doctor will look inside the ear with a special instrument to see if an infection is present and evaluate ear function. If mastoiditis is suspected, your doctor may recommend other tests to confirm the diagnosis, including:

  • blood tests
  • X-ray
  • ear culture (removal of fluid or other substances from the ear to check for infection)

If severe infection is suspected, your doctor may also recommend more in depth tests, such as a CT scan or MRI. If your doctor is concerned you may have developed meningitis as a result of mastoiditis, a lumbar puncture will be performed to test spinal fluid for infection.

Mastoiditis Treatments

Chronic mastoiditis is treated with oral antibiotics, eardrops, and regular ear cleanings by a doctor. If these treatments do not work, surgery may be necessary to prevent further complications.

If you or your child is diagnosed with acute mastoiditis, you may be put in the hospital to receive treatment and care by an otolaryngologist, a doctor who specializes in ear, nose, and throat disorders. Antibiotics will be given through an IV (intravenous line) to treat the infection.

Surgery may also be needed to drain the fluid from the middle ear, called a myringotomy. During a myringotomy, the doctor makes a small hole 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 ventilate and prevent fluid from getting into the middle ear. Typically, the tube will fall out on its own after six to 12 months.

If the infection is severe, a mastoidectomy surgical procedure may be needed to remove the infected bone behind the ear.

If left untreated, mastoiditis can cause serious, even life-threatening, health complications, including hearing loss, blood clot, meningitis, or a brain abscess. But with early and appropriate antibiotic treatment, these complications can be avoided and you can recover completely.

If you are prone to middle ear infections, don't let them go untreated. All bacterial ear infections should receive timely treatment with an appropriate antibiotic to prevent mastoiditis, and other serious health complications.

WebMD Medical Reference

Reviewed by Kimball Johnson, MD on September 01, 2012

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