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mastoiditis
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:
1) signs of acute otitis media are generally present
2) red fluctuant mass behind pinna suggests subperiosteal abscess
3) fever
Laboratory:
-> complete blood count (CBC)
Radiology:
1) radiographs of mastoid air cells
a) frequently show fluid or mucosal thickening
b) destruction of trabeculae & honeycombing suggest severe infection
2) computed tomography (CT) when subperiosteal abscess is clinically suspect
Complications:
1) conductive hearing loss, sensorineural hearing loss & mixed hearing loss
2) labyrinthitis
3) paralysis of ipsilateral facial nerve (cranial nerve 7)
Differential diagnosis:
1) cholesteoma
2) otitis media
Management:
1) see otitis media
2) intravenous antibiotics & emergency surgical mastoidectomy for severe infection indicated by high fever, leukocytosis & radiologic evidence of destruction of mastoid air cells
3) surgical drainage of abscess
Related
mastoid air cells
otitis media
General
otorhinolaryngologic disease; ear, nose & throat (ENT) disease
inflammation
bone disease; osteopathia
References
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 518
- 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: 19171605