Mastoiditis – Causes, Symptoms, Diagnosis and Treatment

Published: 02nd April 2008
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Mastoiditis is an infection of the spaces within the mastoid bone. It is almost always associated with otitis media, an infection of the middle ear. In the most serious cases, the bone itself becomes infected. It may spread into small cavities in the bone, blocking their drainage. Very severe cases infect the whole middle ear cleft.

Mastoiditis is an inflammation or infection of the mastoid bone, which is a portion of the temporal bone. The mastoid consists of air cells that drain the middle ear. Mastoiditis occurs equally in males and females. Mastoiditis most commonly affects children. Mastoiditis develops when middle ear inflammation spreads to the mastoid air cells, resulting in infection and destruction of the mastoid bone. Some symptoms and signs of mastoiditis to pain and tenderness in the mastoid region, as well as swelling. It may have ear pain (otalgia), and the ear or mastoid region can be red (erythematous).

Mastoiditis is usually a consequence of a middle ear infection (acute otitis media). The infection may spread from the ear to the mastoid bone of the skull. The mastoid bone fills with infected materials and its honeycomb-like structure may deteriorate.
Mastoiditis most commonly affects children. Before antibiotics, mastoiditis was one of the leading causes of death in children. Now it is a relatively uncommon and much less dangerous disorder.

Sign and symptoms may include the following :
· Headache.
· Redness of the ear.
· Swelling of the ear lobe .
· Fever.
· Discomfort


Computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that produces cross-sectional images (often called slices), both horizontally and vertically, of the body.

Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

lumbar puncture - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.

Treatment of Mastoiditis
Treatment of mastoiditis consists of intense parenteral (intravenous or intramuscular) antibiotic therapy.
If bone damage is minimal, myringotomy drains purulent fluid and provides a specimen of discharge for culture and sensitivity testing.

Treatment for mastoiditis consists of intense parenteral antibiotic therapy. Reasonable initial antibiotic choices include ceftriaxone with nafcillin or clindamycin. If bone damage is minimal, myringotomy or tympanocentesis drains purulent fluid and provides a specimen of discharge for culture and sensitivity testing. Recurrent or persistent infection or signs of intracranial complications necessitate simple mastoidectomy. This procedure involves removal of the diseased bone and cleaning of the affected area, after which a drain is inserted
Surgery to remove part of the bone and drain the mastoid (mastoidectomy) may be needed if antibiotic therapy is not successful. Surgical drainage of the middle ear through the eardrum (myringotomy) may be needed to treat the underlying middle ear infection.

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