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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 a honeycomb of air cells that drain into 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 a 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 recur. Mastoiditis may be caused by various bacteria. The risk of mastoiditis is reduced with the use of antibiotics for ear infections.

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:

The symptoms of mastoiditis may resemble other medical conditions or problems. Always see 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 the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.

Your child's physician may also order the following tests to help confirm the diagnosis:

If your child has symptoms of mastoiditis, your child's physician may order the following:

If your child has symptoms of meningitis, your child's physician may order a:

Treatment for mastoiditis

The specific treatment for this condition depends on many factors and is tailored for each child. Please discuss your child's condition, treatment options and your preferences with your child's physician or healthcare provider.

Treatment of mastoiditis usually requires hospitalization and a complete evaluation by a physician who 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 (myringotomy) and/or mastoid bone (mastoidectomy).

A myringotomy is a surgical procedure that 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 reaccumulating. The tubes usually fall out on their own after six to twelve months.

A mastoidectomy is performed by making a surgical opening into the mastoid air cells from behind the auricle and draining the infection.

What are the effects of mastoiditis?

If the infection continues to spread, despite antibiotic and/or surgical therapy, the following complications may occur:

Early and proper treatment of mastoiditis is necessary to prevent the development of these life-threatening complications.

Discharge instructions

Please review The Children's Hospital of Philadelphia discharge instructions for Tympanoplasty and/or Tympanomastoidectomy.

Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009

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