Mastoiditis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
An infection of the mastoid bone, which is situated behind the ear, is known as mastoiditis. A bacterial infection that originates in the middle ear is typically the reason. In addition to fever, headaches, and hearing loss, mastoiditis can produce discomfort, swelling, and redness behind the ears. Serious side effects from mastoiditis include meningitis, brain abscess, and facial paralysis if treatment is not received.
Causes
Otitis media, another name for a middle ear infection, is the primary cause of mastoiditis. The air-filled area beneath the eardrum, which houses the tiny ear bones, is affected by this frequent ailment. The eustachian tube, which joins the ear to the throat, can allow bacteria or viruses to enter the ear and produce a middle ear infection. The eustachian tube aids in middle ear fluid drainage and pressure equalization. However, allergies, colds, or sinus infections can occasionally cause the eustachian tube to swell or get clogged. This may cause inflammation and infection by trapping fluid and germs in the middle ear.
The mastoid bone is a hollow structure that contains air cells, and it can occasionally get infected with a middle ear infection. The mastoid bone aids in controlling the ear's pressure and temperature. Nevertheless, the air cells in the mastoid bone may fill with pus and fluid in the event of an infection, which will cause the bone to enlarge and disintegrate. This may cause harm to the brain, blood vessels, and nerves in the vicinity.
Symptoms
The symptoms of mastoiditis can vary depending on the severity and extent of the infection. The most common symptoms include:
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Pain, tenderness, and swelling behind the ear
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Redness and warmth of the skin over the mastoid bone
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Fever and chills
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Headache and dizziness
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Hearing loss or ringing in the ear
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Ear discharge or bleeding
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Nausea and vomiting
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Difficulty opening the mouth or moving the face
Some people may not have any symptoms, especially if they have a mild or chronic infection. However, even without symptoms, mastoiditis can still cause serious complications if not treated promptly.
Diagnosis
A medical history and physical examination are used to diagnose mastoiditis. The ear and the mastoid bone will be examined by the doctor for indications of infection, such as redness, swelling, or soreness. In addition, the doctor will inquire about any history of ear infections or other possible ear-related problems, as well as the symptoms and their length.
The doctor may also order some tests to confirm the diagnosis and to rule out other causes of ear pain or hearing loss. These tests may include:
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Blood tests: To check for signs of infection, such as elevated white blood cell count or inflammation markers.
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Ear swab: To collect a sample of fluid or pus from the ear and test it for the type of bacteria or virus that is causing the infection.
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Imaging tests: To take pictures of the ear and the mastoid bone and look for signs of inflammation, fluid, or damage. These tests may include X-rays, CT scans, or MRI scans.
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Lumbar puncture: To collect a sample of cerebrospinal fluid (CSF) from the lower back and test it for signs of meningitis, which is an infection of the membranes that cover the brain and spinal cord.
Treatment
The treatment of mastoiditis depends on the severity and extent of the infection. The main goals of treatment are to clear the infection, relieve the symptoms, and prevent the complications. The treatment options include:
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Antibiotics: To kill the bacteria that are causing the infection. Antibiotics are usually given by mouth, but in severe cases, they may be given intravenously (through a vein) or intratympanically (through the eardrum).
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Pain relievers: To reduce the pain and fever. Pain relievers may include acetaminophen, ibuprofen, or naproxen. Aspirin should be avoided in children and teenagers, as it can cause a rare but serious condition called Reye syndrome.
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Ear drops: To help drain the fluid and pus from the ear and reduce the inflammation and infection. Ear drops may contain antibiotics, steroids, or antiseptics.
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Surgery: To remove the infected tissue and fluid from the mastoid bone and the middle ear. Surgery may be needed if the infection does not respond to antibiotics, if the mastoid bone is severely damaged, or if there are complications, such as meningitis, brain abscess, or facial paralysis. The types of surgery may include:
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Myringotomy: To make a small hole in the eardrum and insert a tube to drain the fluid and pus from the middle ear. The tube usually falls out on its own after a few months.
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Mastoidectomy: To remove part or all of the mastoid bone and the infected tissue and fluid. The surgeon may also repair the eardrum and the small bones of the ear if they are damaged.
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Tympanoplasty: To reconstruct the eardrum and the small bones of the ear if they are damaged or missing.
Prevention
Mastoiditis can be prevented by preventing and treating ear infections. Some of the preventive measures include:
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Practicing good hygiene: To wash the hands frequently and avoid sharing earphones, earbuds, or other objects that may carry germs.
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Avoiding smoking and secondhand smoke: To reduce the risk of ear infections and other respiratory problems.
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Getting vaccinated: To protect against certain bacteria or viruses that can cause ear infections, such as pneumococcus, haemophilus influenzae type b, or influenza.
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Treating allergies and colds: To reduce the inflammation and congestion that can block the eustachian tube and trap the fluid and bacteria in the middle ear.
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Seeking medical attention: To consult a doctor if there are signs or symptoms of an ear infection, such as ear pain, fever, or hearing loss, and to follow the prescribed treatment and follow-up care.
