Mastoiditis
Mastoiditis is an infection of the mastoid bone, the prominent bone of the skull located just behind the ear. In mastoiditis, the hollow cells of the mastoid, known as mastoid air cells, become filled with infected material. Mastoiditis, like other infections, may be acute or chronic. Chronic mastoiditis is more likely to require surgical intervention.
Causes of Mastoiditis
The primary cause of mastoiditis is a middle ear infection, or otitis media, that has spread to the mastoid bone. Mastoiditis most often affects children since their small ear canals make them more susceptible to ear infections. Another possible cause of mastoiditis is an infected cholesteatoma, or skin cyst, in the ear canal. A cholesteatoma in the middle ear may keep ear fluid from draining and allow bacteria to grow rapidly which, in turn, may lead to mastoiditis.
Symptoms of Mastoiditis
Since symptoms of mastoiditis are often similar to those of a middle ear infection it is necessary to receive medical attention for a proper diagnosis to be made. Mastoiditis is a further complication of an ear infection and may be more serious. Symptoms of mastoiditis may include the following:
- Ear pain
- Fever
- Lethargy or irritability
- Hearing loss
- Headache
- Redness or swelling of the ear or behind it
- Drooping or bulging of the ear
- Drainage of pus from the ear
Diagnosis of Mastoiditis
Mastoiditis is often suspected as a result of the history of patient symptoms and is frequently visible during a physical examination of the head. Other diagnostic tests, administered to assess infection or to rule out other possibilities for the patient's symptoms, may include:
- Blood tests
- Hearing tests
- X-rays
- CT scans of the ear and head
- Bacterial analysis of material drained from the ear
- Analysis of spinal fluid if meningitis is suspected
Treatment of Mastoiditis
The usual treatment of mastoiditis is the administration of antibiotics. In most cases, the antibiotics are first administered by injection and then as an oral course of treatment. Mastoiditis may be difficult to treat because of the depth of the mastoid bone and may require long-term treatment. If antibiotic treatment does not succeed in curing the infection, surgery may be necessary. Surgeries that may be recommended are a myringotomy to drain fluid, a tympanoplasty to repair the eardrum, or a mastoidectomy to remove the diseased part of the mastoid bone.
With antibiotic treatment or surgery, mastoiditis is a curable condition. Because of the location of the mastoid bone, however, the infection may be difficult to treat and may recur.