Hearinginfo.org  © Copyright. No copying without prior written permission	Diseases and Disorders of the Ear
Mastoiditis - Infections of the Mastoid Bone

Mastoiditis

Mastoiditis is an inflammation or infection of the mastoid bone, that sits behind the ear. The mastoid consists of air cells that drain the middle ear.

Causes of Mastoiditis

Mastoiditis is usually a result of a middle ear infection that is left untreated and spreads to the mastoid bones. Mastoiditis usually occurs in children, but can occur in adults.

Symptoms of mastoiditis

The following are the most common symptoms for mastoiditis:

• Already present or recent middle-ear infection
• Redness or swelling of the bone behind the ear (mastoid bone), sometimes with pain
• Swelling or infection of the ear lobe (perichondritis)
• Fever 

Mastoiditis diagnosis

• Fever
• Tenderness and sensitivity to any pressure on the mastoid bone behind the ear
• Blood test shows high white cell count denoting an infection
• Culture from any discharge from the infected ear
• Sore throat with swollen lymph nodes
• In rare cases x-rays of the head will be taken

Other Rarer diagnoses

In very rare cases, a brain abscess or other cranial complication may be indicated.

Symptoms:

The symptoms for this diagnosis (in addition to any of the above) are:

• Severe and blinding headaches
• Papilledema - a swelling of the optic disk (the back of the eyeball) indicating that something in the brain cavity is pressing outward into the eye socket. (Easily seen by using a scope w/ a special tip)

All diagnoses for cranial causes are verifiably diagnosed through imaging technology:

• 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 (spinal tap)-  A small amount of cerebral spinal fluid (CSF) is removed from the lower spinal cord by inserting a needle and obtaining a sample. A test is then performed for infectious elements that may also indicate spinal meningitis.

Treatment for mastoiditis

Mastoiditis is a potentially serious infection, and as a result, any mastoiditis treatment will probably be done in a hospital setting for about 3-5 days. Antibiotics are given 24 hours a day intravenously.

To assist the ear in getting rid of any excess fluid, surgery may be indicated (myringotomy), where a small opening is made in the eardrum for any fluids and bacterial wastes to drain.  Besides the incision, the surgeon will usually also leave a small draining tube to prevent fluid from accumulating.

Non-Treatment results

If the infection continues to spread, despite antibiotic therapy, the following complications may occur:

• meningitis - an infection of the brain membrane.
• brain abscess - a pocket of pus and infection that may develop in the brain. This condition is usually a secondary result of some type of infectious agent in the brain.