Mastoiditis
Definition
Inflammation of the mucosal lining of the mastoid antrum and mastoid air cell system inside the mastoid process of the skull
Aetiology & Incidence
An infection tht extends into the mastoid antrum from otitis media (middle ear infection)
After the advent of antibiotics the incidence has drastically reduced.
Untreated the infection can spread to surrounding structures, including the brain
Clinical Manifestations
Pain, tenderness and swelling in the mastoid region
Ear pain
Erythema of the mastoid region
Fever
Head ache
In infants non specific symptoms : anorexia, diarrhoea, irritability, brown discharge on the pillow case
Diagnosis
MRI
CT scan
X-rays
Bacteria involved
Streptococcus pneumoniae
Streptoccous pyogenes
Staphylococcus aureus
Haemophilus influenzae
Moraxella catarrhalis
Bacteroides
Fusobacterium
Peptostreptococcus
Mycobacteria
Complications
Choesteatoma
Brain abscess
Prvention and Treatment
Ear infections treated promptly
IV antibiotics
Initially broad spectrum : Ceftriaxone
Long term antibiotic may be needed
Surgical Interventions
Myringotomy
Tympanostomy
Mastoidectomy
