Mastoiditis

From Anvita Health Wiki

Contents 1 Etiology 2 Pathology 3 Clinical-manifestations 4 Laboratory 5 Radiology 6 Complications 7 Differential-diagnosis 8 Management 9 More General Terms 10 Additional Terms 11 References

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

• complete blood count ( CBC)

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, sensorineural & mixed hearing loss
• labyrinthitis
• paralysis of ipsilateral facial nerve ( cranial nerve 7)

Differential-diagnosis

• cholesteoma
• otitis media

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

Additional Terms

• mastoid air cells
• otitis media

References

1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 518
2. 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: [1]

mastoiditis