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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 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:

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:

If your child has symptoms of a brain abscess or other intracranial complication, 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:

Specific treatment for mastoiditis will be determined by your child's physician based on:

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:

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

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