Mastoiditis is a potentially serious infection of the mastoid bone, which is part of the temporal bone of the skull, located behind the ear. Children are more likely to develop mastoiditis than adults. Although it can be very uncomfortable, mastoiditis is highly treatable. Most people with the condition make a full recovery quickly, as long as treatment occurs promptly.
Common Symptoms of Mastoiditis
Mastoiditis typically causes the area behind the ear to become red, swollen and inflamed. This is often painful, and affected individuals may also experience an abnormal discharge from the affected ear. The swelling may become severe enough to make the ear stick out at an angle. Some people with mastoiditis develop hearing loss. They may also feel very tired, with a high-grade fever and a headache.
The mastoid bone contains mastoid cells — pockets of air similar to the structure of a honeycomb. When these cells become infected, mastoiditis develops. The condition often starts as an inner ear infection. However, a condition called cholesteatoma can also lead to mastoiditis. Cholesteatoma causes skin cells to build up abnormally inside the ear. When this happens, the ear cannot drain properly, leading to infection.
If mastoiditis is suspected, the doctor will look at the person’s inner ear using a light and magnifying glass to get a detailed view. If they believe there is an inner ear infection, they may refer the person to an ear, nose, and throat (ENT) specialist for further evaluation. The specialist may take a blood test and a sample of any discharge from the ear. This can help to identify a bacterial infection. Some people may require a CT scan of their head to allow a closer look at the mastoid bone.
Treatment with Medication
If medical practitioners catch mastoiditis early, they may be able to treat the person using medication. Antibiotics can help clear up the bacterial infection. To treat the infection as promptly as possible, the patient may need to go to the hospital to receive intravenous antibiotics through a drip, which will treat the infection more speedily and directly than oral medicines and may help avoid complications.
Surgical Treatment for Mastoiditis
In some cases, the person will require surgical intervention. One option is a myringotomy, a procedure that drains the inner ear. Alternatively, the surgeon may recommend a mastoidectomy. During this procedure, surgeons remove all infected parts of the mastoid bone while the patient is under general anesthetic. A doctor will likely prescribe antibiotics, as well.
Recovering from Surgery
People who have had surgery for mastoiditis should stay off work or school for about one to two weeks until the wound has healed and the infection has cleared up. It is important to keep to wound site and affected ear dry for around a week, and most experts recommend people avoid swimming for at least a month. A doctor may give additional instructions for recovery depending on individual factors, such as how much of the mastoid bone was removed.
Most people with mastoiditis recover without complication. However, treatment can sometimes be difficult, and the condition could reoccur. Mastoiditis can cause hearing loss, vertigo, and facial paralysis. A severely infected mastoid bone requires removal to avoid life-threatening blood clots. Other severe complications include meningitis and abscesses on the brain.
Lateral Sinus Thrombosis
Lateral sinus thrombosis is a rare complication of mastoiditis. It occurs mainly in children, although adults have been known to develop it as well. People with lateral sinus thrombosis often have a severe fever, vomiting, and a headache. They may complain of double vision and other visual disturbances. CT or MRI scans diagnose the condition. A lack of fluid flow in the sinuses of the brain is the main sign that a person has lateral sinus thrombosis. The condition requires prompt treatment with antibiotics.
Many cases of mastoiditis are unavoidable. However, preventing ear infections by keeping the ears clean and dry and keeping children away from second-hand smoke are useful measures. If a person develops an ear infection, seeking prompt treatment to clear up the infection can prevent it from spreading to the mastoid bone.
When to Seek Help
It is important to receive prompt treatment for ear infections and follow up with a doctor if the infection does not go away or returns. Taking such care can prevent more minor infections from progressing to mastoiditis. Anybody diagnosed with mastoiditis should seek medical care if their condition does not improve or returns.