Mastoiditis

Mastoiditis is an infection that has spread from the middle ear to a bony area (the mastoid air cells) behind the middle ear. It is an uncommon complication of a middle ear infection. It occurs most often in young children. Treatment with the right antibiotics (medications that are used to treat bacteria germs) is generally effective. With the right treatment, there is a very high chance of full recovery.

SYMPTOMS

Some common symptoms of mastoiditis include:

  • Pain, swelling, redness, warmth, or a tender mass of the bone behind the ear.

  • Fever.

  • Fussiness and irritability.

  • Redness and swelling of the ear lobe or ear.

  • Ear drainage.

  • Headache.

DIAGNOSIS

Your caregiver will make the diagnosis based on an exam and on questions about what you or your child has been feeling. Other tests that may be done include:

  • Blood work.

  • Blood cultures or cultures of ear drainage.

  • X-rays.

  • If you or your child has symptoms that suggest more serious problems, additional tests and/or specialized x-rays may be done. These could include:

  • CT (CAT) scans.

  • Magnetic Resonance Imaging (MRI).

TREATMENT

Treatment will be based on how serious the infection is and what will be expected to give the best outcome. The treatment required may be:

  • Hospitalization and antibiotics given through a vein.

  • An operation (myringotomy) is sometimes done to relieve the pressure from the middle ear. This is a surgical procedure where a small hole is cut into the ear drum. A small tube is then placed to keep the hole open and draining. The tubes usually fall out on their own after 6 to 12 months.

  • In rare cases, if the above treatments do not work, more surgery may be necessary. This is called a mastoidectomy.

RISKS AND COMPLICATIONS

These are rare if proper treatment is started early. These can include:

  • Facial paralysis

  • Infection and possible destruction of the mastoid bone.

  • Spread of infection to the neck.

  • Hearing loss which can be partial or complete on the side of the infection.

  • Infection spread to the brain.

  • Clots or blockage of blood vessels in the neck or brain.

HOME CARE INSTRUCTIONS

  • Take prescribed antibiotics and other medications as directed by your caregiver.

  • Follow-up with an exam by an ENT (Ear, Nose, and Throat) specialist if recommended.

  • A follow-up hearing test (audiogram) may be recommended.

SEEK MEDICAL CARE IF:

  • You develop recurrent fevers of 100° F (37.8° C) or higher.

  • You develop new headache, ear, or facial pain that had not happened before.

  • You feel that there has been loss of hearing.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop fevers of 102° F (38.9° C).

  • You develop severe headache, ear, or facial pain.

  • You experience sudden hearing loss.

  • You develop repeated episodes of vomiting.

  • You develop weakness or drooping of one side of your face.

  • You experience weakness of one arm, one leg, or on one side of your body.

  • You develop sudden problems with speech and/or vision.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.