mastoiditis
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Etiology
- 1/3 of patients with mastoiditis have a history of acute otitis media[2]
Pathology
- mastoid air cells communicate with the inner ear, thus mastoitis & otitis media may share a common origin
Clinical manifestations
- signs of acute otitis media are generally present
- red fluctuant mass behind pinna suggests subperiosteal abscess
- fever
Laboratory
Radiology
- radiographs of mastoid air cells
- frequently show fluid or mucosal thickening
- destruction of trabeculae & honeycombing suggest severe infection
- computed tomography (CT) when subperiosteal abscess is clinically suspect
Complications
- conductive hearing loss, sensorineural hearing loss & mixed hearing loss
- labyrinthitis
- paralysis of ipsilateral facial nerve (cranial nerve 7)
Differential diagnosis
Management
- see otitis media
- intravenous antibiotics & emergency surgical mastoidectomy for severe infection indicated by high fever, leukocytosis & radiologic evidence of destruction of mastoid air cells
- surgical drainage of abscess
More general terms
- otorhinolaryngologic disease; ear, nose & throat (ENT) disease
- inflammation
- bone disease; osteopathia
Additional terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 518
- ↑ 2.0 2.1 Thompson PL et al. Effect of antibiotics for otitis media on mastoiditis in children: A retrospective cohort study using the United Kingdom General Practice Research Database. Pediatrics 2009 Feb; 123:424. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19171605