MASTOIDITIS

DEFINITION
• Mastoiditis is a bacterial infection of the
mastoid bone.( CONSISTE AIR SPACE HELP
DRAIN MIDDLE EAR)
• When the mastoid cells become infected or
inflamed, often as a result of an unresolved
middle ear infection (otitis media), mastoiditis
can develop.
 INCIDENCE
• CHILDRENS ARE FREQUENTLY AFFECTED
WHEN COMPARED TO ADULT.
 ETIOLOGY
• Host factors-mucosal immunology, temporal bone anatomy, and systemic
immunity.
• Microbial factors
• Reported pathogens in mastoiditis include the following:
• Streptococcus pneumoniae – Most frequently isolated pathogen in acute
mastoiditis, prevalence of approximately 25%
• Group A beta-hemolytic streptococci
• Staphylococcus aureus
• Streptococcus pyogenes
• Moraxella catarrhalis
• Haemophilus influenzae
• Pseudomonas aeruginosa
• Mycobacterium species
• Aspergillus fumigatus and other fungi
PATHOPHYSIOLOGY
 CLINICAL MANIFESTATIONS
• Fever, irritability, and lethargy
• Swelling of the ear lobe
• Redness and tenderness behind the ear
• Drainage from the ear
• Bulging and drooping of the ear (in acute
mastoiditis)
• Headache and ear pain
• Otorrhea
• Vertigo
 DIAGNOSTIC EVALUATIONS
• blood tests
• X-ray
• ear culture (removal of fluid or other
substances from the ear to check for infection)
• If doctor is concerned about developed
meningitis as a result of mastoiditis, a
lumbar puncture will be performed to test
spinal fluid for infection
 MANAGEMENT
• The principal medications used in the
treatment of mastoiditis are antibiotics. Other
medications include analgesics, antipyretics,
and topical antibiotic-steroid combinations.
Linezolid (Zyvox), Cefepime (Maxipime),
Ceftriaxone (Rocephin).IV ANTIDIOTICSFOR 1-
2 DAYS AFTERWARDS ORAL ANTIBIOTICS.
 SURGICAL MANAGEMENT
• Surgical therapy confined to the ear includes
myringotomy/tympanocentesis,
tympanostomy tube placement, and
mastoidectomy.
 complications
• Impaired hearing
• Speech or developmental delays. If hearing is
temporarily or permanently impaired in
infants and toddlers, they may experience
delays in speech, social and developmental
skills
• Tearing of the eardrum
• MENINGITIS
• FACIAL NERVE PALSY(INFECTION MAY SPREAD
THROUGH FACIAL NERVE)