Everything you need to know about mastoiditis

Mastoiditis is an uncommon illness of the mastoid bone behind the ear. Unresolved ear infections commonly cause it. If neglected, ear infections can progress to the mastoid bone. The cells within this bone are loaded with air and have a honeycomb-like shape, which leads to its degeneration due to infection.

Mastoiditis is now relatively uncommon, and life-threatening consequences are rare. It is more common among children. Mastoiditis was one of the most common causes of death in kids before antibiotics were developed.

What is mastoiditis, exactly?

Mastoiditis is an inflammation of the skull’s mastoid bone. The mastoid bone can be found behind the ear. A recurrent ear infection commonly triggers mastoiditis. If you have a severe illness that affects your immune system, you may be more susceptible to mastoiditis. Your ear canal expands, and fluid becomes trapped inside. Bacteria proliferate and grow on your mastoid bone as a result of the confined fluid.

What Triggers Mastoiditis?

The most prevalent cause of mastoiditis is ear infections, especially middle ear infections (otitis media). Without prompt treatment, the germs can spread. This may occur, for instance, if a patient decides to abandon treatment before it is completed. It’s also possible if the bacteria are resistant to the medications provided.

Mastoiditis is most caused by an obstruction resulting from the abnormal development of skin cells in the middle ear, known as cholesteatoma. Cholesteatomas can also lead to ear polyps, leading to more blockage.

Signs and Symptoms of Mastoiditis

Mastoiditis indications can appear after an ear infection has cleared up. It can sometimes appear that an ear infection has worsened. A physician may consider testing for mastoiditis if an individual with a viral ear infection gets new indications while on treatment. Among the signs and symptoms are:

  • Severe, pulsating pain in or around the ear
  • Abscess or other substances oozing from the ear
  • A high temperature or chills
  • Swelling below or beneath the ear
  • Behind-the-ear inflammation
  • A foul odour emanating from the ear
  • The ear is protruding or being pushed forward
  • Hearing difficulties, such as ringing in the ears
  • An ache that appears out of scale

The following are some symptoms of mastoiditis in very young children:

  • Mood swings
  • A lot of tears
  • Smacking them on the side of the head
  • Grabbing their ears

Mastoiditis-induced swelling improves, then worsens in some people. It is critical not to assume that an infection resolves when symptoms diminish marginally. Mastoiditis, if left untreated, can induce blood clots or progress to sepsis, a potentially fatal blood infection.

Anybody suffering from mastoiditis or an ear infection experiencing disorientation, a high temperature, considerable weakness, or swelling around their head should seek urgent medical attention.

Diagnosis and Treatment

Your children’s doctor will use an otoscope to view the outer ear(s) and eardrum(s) to get a comprehensive health background and physical check-up. An otoscope is a light tool that enables a doctor to look within the ear. A pneumatic otoscope blows air into the ear to check for eardrum motion.

Tympanometry is a test that can be done in most doctors’ offices to assess how well the middle ear is working. It cannot determine whether your child can hear, but it can detect changes in middle ear pressure. This is a tough test for smaller kids since they must sit perfectly still and not cry, talk, or move.

To help verify the condition, your child’s doctor may additionally conduct the following tests:

  • Blood tests: These can reveal infections or details about your general health.
  • Head X-rays: a diagnostic technique that uses invisible electromagnetic energy beams to make images of the interior tissues and bones of the head onto film.
  • A culture from an infected ear: this is a test of the fluid drained from your ear. Fluid cultures can reveal the bacteria that is causing the ailment. To get a fluid sample, your healthcare professional may have to inject a small needle with a tube into your ear.

If your kid shows symptoms of a brain abscess or another intracranial issue, their doctor may perform the following tests:

  • A CT scan is a diagnostic imaging method that employs x-rays and computer technology to create cross-sectional images (commonly referred to as “slices”) of the body, horizontally and vertically. A CT scan provides detailed images of any region, such as the bones, muscles, fat, and organs. CT scans provide more information than standard x-rays.
  • Magnetic resonance imaging (MRI) is a diagnostic process that produces comprehensive photographs of anatomical structures within the body by combining huge magnets, radio frequencies, and a computer.

If your child has meningitis indications, your child’s doctor may prescribe:

Lumbar puncture: a specific needle is inserted into the lower back, into the spinal canal. This is the region around the spinal cord. The tension in the spinal canal and brain can be monitored. A small sample of cerebrospinal fluid (CSF) can be extracted and tested to see if there is an infection or other issues. CSF is the fluid that surrounds your child’s brain and spinal cord.

Mastoiditis Treatment

Treatment normally entails hospitalization and a thorough examination by an ear, nose, and throat specialist (otolaryngologist). In most circumstances, your kid will be given antibiotics using an intravenous (IV) catheter. Occasionally, surgical intervention is required to drain fluid from the middle ear.

Your child’s doctor may recommend a myringotomy, a surgical technique that involves creating a small incision in the eardrum to drain fluid and reduce tension in the middle ear.

  • A tiny tube may be inserted through the eardrum hole to ventilate the middle ear and avoid fluid accumulation.
  • Your kid’s hearing will recover after the fluid is evacuated. The tubes usually fall out on their own after six to twelve months.


Receiving good treatment for ear infections is the best way to avoid mastoiditis. If your doctor recommends antibiotics, you must complete the entire course of therapy as directed, even if your symptoms improve. It’s simpler for the illness to recur if you merely take a partial dose of antibiotics.

Antibiotics leftover from a previous sickness should not be taken. It is vital to use the appropriate antibiotics for each infection.

To lower your chances of getting an ear infection, wash your hands frequently and thoroughly and avoid contact with sick individuals. Anybody with a weaker immune system, whether from HIV, diabetes, or certain medicines, should seek medical advice on the symptoms of an infection.

Mastoiditis-related Risks

Mastoiditis is tough to treat since the mastoid bone is located deep inside your ear. Severe health complications may occur if treatment is ineffective or if the infection is not addressed before it damages the mastoid. Among these health issues are:

  • dizziness or vertigo
  • facial paralysis
  • hearing loss
  • Meningitis is a bacterium of the membranes surrounding your brain and spinal cord.
  • An accumulation of pus on the exterior of your brain and spinal cord is known as an epidural abscess.
  • Sepsis is an illness that spreads across your body.

Bottom Line

Anyone experiencing severe ear pain and swelling should seek medical help. In kids who have recently had an ear infection and have discomfort or swelling around that ear, look for any mastoiditis indications.

Ear infections are a frequent paediatric condition that can have significant consequences, such as mastoiditis. A medical practitioner can offer guidance and make treatment recommendations. If your symptoms do not resolve in a few days, go to your doctor or get a second opinion.

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