MASTOIDITIS

Mastoid process is the portion of the temporal bone of the skull that is behind the ear which contains open, air- containing spaces

it is an inflammation of the mucosal lining of the mastoid air cell system inside the mastoid process Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear

Types Acute mastoiditis - sudden occurrence of inflammation may spread outside the mastoid bone and cause serious problems Chronic mastoiditis – in chronic type of mastoiditis there will be ongoing middle ear infection and persistent drainage from the ear.

Causes Mastoidits is usually caused by untreated acute otitis media Cholesteatoma in the middle ear may block drainage of the ear leading to mastoiditis Causative organisms Streptococcus pneumonia, streptococcus pyogenes, staphylococcus aureus, heamophilus influenzae and morexalla catarrhalis

Signs and symptoms Pain, tenderness and swelling in the mastoid region Otalgia, redness over the mastoid region Fever , headaches Drainage from the ear occurs in more serious cases Irritability and lethargy

Diagnosis History collection Physical examination MRI CT scan Culture of the drainage Blood tests

Management Antibiotics – ceftriaxone IV Myringotomy or tympanostomy to insert a tympanostomy tube into the ear drum to the inner ear for draining. Mastoidectomy – a procedure in which a portion of the mastoid bone is removed and the infection drained. A second surgery may do after mastoidectomy to correct the ossicles and the perforated tympanic membrane. (tympanoplasty and ossiculoplasty)

Types of mastoidectomy Simple mastoidectomy – surgeon opens the mastoid bone, removes the infected air cells, and drains the middle ear Radical mastoidectomy –surgeon remove the eardrum and middle ear structures. Skin graft is placed in middle ear after the procedure Modified radical mastoidectomy – this is less severe form of radical mastoidectomy. Not all middle ear bones are removed and the ear drum is rebuilt. Mastoidectomy also done to place choclear implants

Post operative antibiotics and analgesics will be there Follow up date will fix for the removal of stitches and bandage Cover the operative site while bathing (pertroleum jelly covered cotton ball) Avoid streneous activity Avoid air travel Avoid putting pressure on ear

Complications If left untreated it can cause hearing loss, blood clot, meningitis and brain abscess Complications of surgery Facial nerve paralysis Sensorineural hearing loss Vertigo Change in taste (metallic taste) Tinnnitus