Health Encyclopedia

Mastoiditis

Definition

Mastoiditis is an infection of the mastoid bone of the skull. The mastoid is located just behind the outside ear.

Causes, incidence, and risk factors

Mastoiditis is usually caused by a middle ear infection (acute otitis media). The infection may spread from the ear to the mastoid bone of the skull. The mastoid bone fills with infected materials and its honeycomb-like structure may deteriorate.

Mastoiditis usually affects children. Before antibiotics, mastoiditis was one of the leading causes of death in children. Now it is a relatively uncommon and much less dangerous condition.

Symptoms

Drainage from the ear
Ear pain or discomfort
Fever, may be high or suddenly increase
Headache
Hearing loss
Redness of the ear or behind the ear
Swelling behind ear, may cause ear to stick out

Signs and tests

An examination of the head may reveal signs of mastoiditis. The following tests may show an abnormality of the mastoid bone:

A culture of drainage from the ear may show bacteria.

Treatment

Mastoiditis may be difficult to treat because medications may not reach deep enough into the mastoid bone. It may require repeated or long-term treatment. The infection is treated with antibiotics by injection, then antibiotics by mouth.

Surgery to remove part of the bone and drain the mastoid (mastoidectomy) may be needed if antibiotic therapy is not successful. Surgery to drain the middle ear through the eardrum (myringotomy) may be needed to treat the middle ear infection.

Expectations (prognosis)

Mastoiditis is curable with treatment. However, it may be hard to treat and may come back.

Complications

Destruction of the mastoid bone
Dizziness or vertigo
Epidural abscess
Facial paralysis
Meningitis
Partial or complete hearing loss
Spread of infection to the brain or throughout the body

Calling your health care provider

Call your health care provider if you have symptoms of mastoiditis.

Call for an appointment with your health care provider if:

You have an ear infection that does not respond to treatment or is followed by new symptoms
Your symptoms do not respond to treatment

Prevention

Promptly and completely treating ear infections reduces the risk of mastoiditis.

References

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005:3019-3020.

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005:771.

Review Date:10/10/2008
Reviewed By:Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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