ear, nose, and throat disorders
Mastoiditis
Introduction
Mastoiditis is a bacterial infection of the mastoid air cells, which typically occurs after acute otitis media. Symptoms include redness, tenderness, swelling, and fluctuation over the mastoid process, with displacement of the pinna. Diagnosis is clinical. Treatment is with antibiotics, such asceftriaxone, and, if antibiotics alone are not effective, mastoidectomy. Acute mastoiditis with CT evidence of coalescent mastoiditis warrants urgent tympanostomy tube placement and mastoidectomy. In Otitis Media (Acute) , inflammation often extends into the mastoid antrum and air cells in the temporal bone, resulting in fluid accumulation. In a few patients, bacterial infection develops in the collected fluid, typically with the same organism causing the otitis media; pneumococcus is most common. Mastoid infection can cause osteitis of the septae, leading to coalescence of the air cells (coalescent mastoiditis). The infection may decompress through a perforation in the tympanic membrane or extend through the lateral mastoid cortex, forming a postauricular subperiosteal abscess. Rarely, infection extends centrally, causing a temporal lobe abscess or a septic thrombosis of the lateral sinus. Occasionally, the infection may erode through the tip of the mastoid and drain into the neck (called a Bezold abscess). Consequences can include deafness, sepsis, and/or Overview of Meningitis . 