Mastoiditis
What is mastoiditis?
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 can be a mild infection or can develop
into life-threatening complications. Mastoiditis is usually a complication
of acute otitis media (middle ear infection).
What causes mastoiditis?
Mastoiditis is usually a result of an extension of the inflammation of the
middle ear infection into the mastoid air cells. A child with mastoiditis
usually has a history of having a recent ear infection or has middle ear
infections that continue to reoccur. The risk of mastoiditis is reduced
with the use of antibiotics for ear infections. Mastoiditis may be caused
by various bacteria.
What are the symptoms of mastoiditis?
The following are the most common symptoms for mastoiditis. However, each
child may experience symptoms differently. Symptoms may include:
- pain behind the ear
- swelling of the ear lobe
- recent ear infection
- fever
- irritability
- redness or swelling of the bone behind the ear
- drainage from an ear infection
The symptoms of mastoiditis may resemble other medical conditions or
problems. Always consult your child's physician for a diagnosis.
How is mastoiditis diagnosed?
In addition to a complete medical history and physical examination, your
child's physician will inspect the outer ear(s) and eardrum(s) using an
otoscope. The otoscope is a lighted instrument that allows the physician
to see inside of the ear. A pneumatic otoscope blows a puff of air into
the ear to test eardrum movement.
Tympanometry, a test that can be performed in most physician offices to
help determine how the middle ear is functioning. It does not tell if the
child is hearing or not, but helps to detect any changes in pressure in
the middle ear. This is a difficult test to perform in younger children
because the child needs to sit very still and not be crying, talking, or
moving.
Your child's physician may also order the following tests to help
confirm the diagnosis:
- blood work
- x-rays of the head - a diagnostic test which uses invisible
electromagnetic energy beams to produce images of internal tissues and
bones of the head onto film.
- culture from the infected ear
If your child has symptoms of a brain abscess or other intracranial
complication, your child's physician may order the following:
- computed tomography scan (Also called a CT or CAT scan.) - a
diagnostic imaging procedure that uses a combination of x-rays and
computer technology to produce cross-sectional images (often called
slices), both horizontally and vertically, of the body. A CT scan shows
detailed images of any part of the body, including the bones, muscles,
fat, and organs. CT scans are more detailed than general x-rays.
- 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.
If your child has symptoms of meningitis, your child's physician may
order a:
- 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 for mastoiditis:
Specific treatment for mastoiditis will be determined by your child's
physician based on:
- your child's age, overall health and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures, or
therapies
- expectations for the course of the condition
- your opinion or preference
Treatment of mastoiditis usually requires hospitalization and a
complete evaluation by a physician that specializes in the ear, nose, and
throat disorders (otolaryngologist). Your child, in most cases, will
receive antibiotics through an intravenous (IV) catheter. Surgery is
sometimes needed to help drain the fluid from the middle ear.
Your child's physician may suggest a myringotomy, a surgical procedure
which involves making a small opening in the eardrum to drain the fluid
and relieve the pressure from the middle ear. A small tube may be placed
in the opening of the eardrum to ventilate the middle ear and to prevent
fluid from accumulating. The child's hearing is restored after the fluid
is drained. The tubes usually fall out on their own after six to twelve
months.
What are the effects of mastoiditis?If the infection continues to spread, despite antibiotic
therapy, the following complications may occur:
- meningitis - an infection of the outside of the brain.
- brain abscess - a pocket of pus and infection that may
develop in the brain.
Early and proper treatment of mastoiditis is necessary to prevent the
development of these life-threatening complications.
More Information
Schneider Children's
Hospital Division of Otolaryngology and Communication Disorders
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