Causes and risk factors
Mastoid is a spongy bone made up of multiple air sacs. Any infection from the middle ear can easily extend into the mastoid bone, thus causing mastoiditis. Chronic suppurative otitis media is the commonest cause of acute mastoiditis. It may also occur due to cholesteatoma formation.
Chronic mastoiditis infection is commonly observed in children. Individuals with low immunity are more prone to this infection. The common micro-organisms responsible for the infection include Staphylococci, Streptococci, Mycobacterium, and Haemophilus influenzae.
Clinical presentation
Patient presents with a history of chronic suppurative otitis media or repeated acute otitis media infection. Thus there is a history of repeated fevers, pain, and discharge from the ear.
Very young children with this condition may cry repeatedly and do not feed properly.
Other symptoms of chronic mastoiditis are headache and loss of hearing.
Investigations
A blood test is carried out to measure the complete blood cell count.
Audiometry is done to assess the hearing.
Tympanocentesis – This procedure is performed in which the tympanic membrane is punctured and the fluid is tested for culture and sensitivity.
Imaging tests such as x-rays, CT or MRI scan of the head may be suggested.
Treatment
Chronic mastoiditis is a serious condition and needs aggressive treatment. The patient is first put on intravenous antibiotics and then shifted to oral antibiotics.
If the infection fails to clear up, then surgical intervention becomes necessary. Partial mastoidectomy is performed, wherein a part of the mastoid bone is removed in order to drain it.
In the event of complications such as bone necrosis or abscess formation, surgical intervention becomes necessary. Mastoidectomy (removal of the mastoid bone) is performed with or without tympanoplasty (reconstruction of the tympanic membrane).
Complications
Chronic mastoiditis can give rise to severe complications such as osteomyelitis, deafness, brain infections, palsy of the cranial nerves, petrositis, and vascular complications in the carotid artery.
When to contact a doctor
Contact a doctor as soon as you experience ear pain or ear discharge.
Systems involved
Otology
Organs involved
Ear, brain.
