Q. What is mastoiditis?

A. Mastoiditis is the infection of the mastoid bone present just behind the ear.

Q. What is silent mastoiditis?

A. Silent mastoiditis is a severe type of mastoiditis that involves the degeneration of the mastoid bone without any signs like redness, swelling, or discharge from the ears. Silent mastoiditis is more harmful than mastoiditis as it can lead to severe damage before the patient will notice it and get treatment.

Q. Which doctor will treat mastoiditis?

A. Mastoiditis is treated by an ENT specialist or otolaryngologist.

Q. Can mastoiditis recur after treatment?

A. Yes, mastoiditis can recur after treatment using antibiotics. However, the infection usually does not recur following surgical treatment. The rate of recurrence will depend on the severity of the patient’s condition and the type of treatment being performed.

Q. Is mastoiditis life-threatening?

A. Yes, mastoiditis could be a life-threatening condition as the ear infection can quickly spread to the brain, skull, and the rest of the body causing severe complications. It is therefore important to take proper treatment immediately once you are diagnosed with mastoiditis.

Q. What will happen if I leave mastoiditis untreated?

A. When mastoiditis is not treated in a timely manner, it could cause the following complications: Vertigo Dizziness Changes in vision Paralysis of the face Destruction of the mastoid Hearing loss Epidural abscess (an infection inside the skull or near the spine) Meningitis (an infection leading to the inflammation of the brain and spinal cord membranes) Sepsis (a condition in which the infection spreads throughout the body)

Q. Can mastoiditis occur without an ear infection?

A. Yes, although it is uncommon to get mastoiditis without a coinciding ear infection, it is still a possibility.

Q. Can stress cause mastoiditis?

A. Yes, stress can reduce the immune or disease-fighting capacity of the body and increase the possibility of ear infections. Constant stress can even lead to recurring infections.

Q. Can sinusitis lead to mastoiditis?

A. Yes, acute sinusitis can usually be treated completely using antibiotics while chronic sinusitis can cause the infection to spread to the middle ear and then mastoid bone leading to mastoiditis.

Q. Can mastoiditis be treated completely?

A. The prognosis of mastoiditis is normally excellent in acute mastoiditis and can usually be treated completely using antibiotics. Chronic mastoiditis will need further treatment with surgery. If the infection has spread to other areas of the body like the brain, further types of treatments are needed.

Mastoiditis Treatment at Kauvery Hospital Alwarpet, Alwarpet, Chennai

The mastoid bone is located just behind the ear and has several air cavities that help in protecting the delicate structures of the ear, regulate the ear pressure, and protect the temporal bone during trauma.
These air cavities get infected and filled with discharge during mastoiditis.

Types:

The different types of mastoiditis are:

Chronic mastoiditis: This type of infection lasts for a month or more, or comes back following antibiotic treatment.
Acute mastoiditis: This type of infection usually goes away within a month of treatment and does not return again.

Causes:

Mastoiditis may occur due to the following conditions:

Acute otitis media (middle ear infections)
Cholesteatoma (a benign or non-cancerous cyst that invaded the middle ear and mastoid causing deterioration of the ear canal and permanent loss of hearing)

Risk factors:
The risk of developing mastoiditis is more in the following cases:

Children are more likely to get mastoiditis than adults
Age less than two years
Immunocompromised patients
Abnormal or incomplete air cells formation
Recurrent otitis media

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Symptoms

The symptoms associated with mastoiditis are:

Headache
Loss of hearing
Fever
Swelling, redness, and tenderness behind the ear
Drainage from the ear
Drooping and bulging of the ear

Diagnosis

Physical examination: The doctor will evaluate the physical health of the patient. The doctor will also check for symptoms like posterior ear tenderness, swelling, or redness behind the ear.
Ear examination using an otoscope: The doctor will look through the ear canal by using an otoscope.
Blood tests: Tests like complete blood count (CBC) and white blood cell (WBC) count help in confirming the presence of an infection.
Ear culture: If there is pus coming out from the ears of a child, the doctor will check for bacterial infections.
X-ray of the skull: The image of the inside of the head can be obtained using an x-ray.
CT scan of the ear and head: This test uses x-rays and a computer to create detailed pictures of the inside of the ear and the skull.
MRI scan of the ear and head: This is a type of imaging test that uses strong magnetic fields and radio waves to create detailed images of the inside of the ear and the skull.
Spinal tap or lumbar puncture: If the doctor confirms the diagnosis of mastoiditis, a lumbar puncture procedure may be performed to check if the infection has spread to the spinal column.

Treatment

Non-surgical treatment: It can be performed using the following:
Antibiotics: Antibiotic injections may be given intravenously (injected into the vein) followed by oral antibiotics to treat mastoiditis.

Surgical treatment: If antibiotics fail to treat infection, the following surgeries may be recommended to treat mastoiditis:

Myringotomy: A small hole is made by the surgeon in the eardrum to drain the fluid from the middle ear and relieve pressure. A small tube is then placed into the middle ear to prevent the hole from closing and allow continued drainage. This tube usually falls out on its own after six to twelve months.
Mastoidectomy: The infected part of the child’s mastoid bone is removed through an incision made behind the ear in this type of surgery.

Risks

Untreated mastoiditis may lead to the following complications:

Vision changes
Vertigo
Dizziness
Mastoid bone destruction
Facial paralysis
Epidural abscess (infection inside the skull or near the spine)
Meningitis (inflammation of the brain and spinal cord membranes due to an infection)
Partial or total loss of hearing
Sepsis (spread of infection throughout the body)
The complications associated with surgery performed to treat mastoiditis may include the following:
Injury to the facial nerve
Hearing loss
Infection
Bleeding
Dizziness
Tinnitus
Alterations in taste
Cerebrospinal fluid (the fluid that surrounds the brain and the spinal cord) leakage
Need for revision surgery

After Procedure

The following are the post-procedure steps following surgery for mastoiditis treatment:

The patient needs to take one or two weeks off from school or work after surgery.
It is normal to experience an altered taste in the mouth for a few days after surgery.
It is normal to have some jaw swelling after surgery. This swelling usually disappears on its own in a few days.
It is normal to have some ear pain and discomfort after the procedure. The doctor will prescribe pain-relieving medications for the same.
The doctor may prescribe antibiotic medications to prevent infection after surgery.
Follow all the instructions of your doctor for a rapid and smooth recovery.

Home remedies:

The following home remedies are useful following mastoiditis treatment by surgery:

Avoid keeping your mouth open while sneezing or coughing.
Avoid exercising for a few months after the surgery.
Avoid swimming during the recovery period.
Place some cotton in the ears before taking a bath to prevent any water from entering the ears.
Keep your head in an elevated position while sleeping.
Avoid moving your head excessively during the recovery period.
Avoid lifting heavy objects and strenuous activities during the recovery period.

Prevention:

The following tips can help in avoiding middle ear infections that may lead to mastoiditis:

Quit smoking
Limit the use of pacifiers for babies
Prevent getting a cold
Control allergies
Use preventive antibiotics to remove infection
Cover your mouth while coughing or sneezing
Wash your hands frequently
Take the pneumococcal vaccine

Cost of mastoiditis treatment in India-

The cost of mastoiditis treatment using medications is between INR 2,000 to INR 3,000.
The cost of surgery for mastoiditis treatment in Mumbai is between INR 55,000 to INR 80,000.
The cost of surgery for mastoiditis treatment in Delhi is between INR 50,000 to INR 75,000.
The cost of surgery for mastoiditis treatment in Bangalore is between INR 50,000 to INR 75,000.
The cost of surgery for mastoiditis treatment in Chennai is between INR 45,000 to INR 70,000.