Mastoiditis is an infectious process, expressed by inflammation of the mastoid process of the temporal bone. As a rule, this disease is a complication in acute otitis media. The main manifestations of the condition are increased body temperature, hearing loss, ear pain and general intoxication.
Reasons
As a rule, the secondary cause of this disease is the pathogenic activity of an infection that has penetrated from the tympanic cavity. The main causative agents of the disease are staphylococci, streptococci, pneumococci, etc. Infection penetrates from the eardrum when its drainage process is disrupted, when there is an insufficient opening in the eardrum or when it is closed. In some cases, mastoiditis is a consequence of infection with tuberculosis or syphilis.
The development of primary mastoiditis is caused by traumatic injuries of the mastoid process in traumatic brain injuries, gunshot wounds, blows. In this case, the blood that is poured into the cells of the process becomes a favorable area for the development of pathogenic flora.
The presence of chronic diseases, weak immunity, congenital and acquired pathologies of the nasopharynx and changes in the structure of the ear can provoke this disease.
Symptoms
Mastoiditis can manifest itself when purulent otitis occurs, one or two weeks after the development of clinical manifestations of the first.
For adults, the manifestation of this disease is accompanied by a significant deterioration in the general condition, namely, fever, sleep disturbance, headache and intoxication. Patients are concerned about pulsation in the area of the mastoid process, severe pain behind the ear, hearing impairment, against the background of the appearance of noise in the ear. Pain can radiate to the upper jaw, parietal and temporal region.
All of the above signs are noted against the background of abundant suppuration from the ear. In some cases, the volume of pus secreted is much larger than the volume of the eardrum, which indicates the active spread of the inflammatory process beyond the middle ear.
Suppuration can be subtle or insignificant, which indicates the preservation of the eardrum and the closed hole in it, which prevents the outflow of pus into the middle ear from the mastoid process.
Mastoiditis occurs with redness and swelling of the occipital area, which are very noticeable. There is also a smoothing of the skin fold behind the ear and a characteristic protrusion of the auricle.
If there is a breakthrough of pus into subcutaneous fat, then an abscess is formed. It is characterized by the appearance of soreness during palpation of the posterior region. With the spread of pus into the soft tissues of the temporal and parietal regions, vascular blockage and periosteal necrosis occur, with the breakthrough of pus to the surface with the formation of a fistula.
Diagnostics
Mastoiditis is diagnosed by an otolaryngologist based on a visual examination. Difficulties with the diagnosis of this disease may occur with an atypical, low-symptomatic form of the disease.
The diagnosis is established after analyzing the patient’s complaints and collecting anamnesis about head injuries or inflammatory processes of the middle ear. When examining the patient, palpation of the behind-the-ear area is performed. As additional studies, otoscopy, radiography, CT, and back-seeding of secretions from the ear are prescribed.
Treatment
Mastoiditis is treated depending on its stage of development, etymology and the presence of complications.
Drug therapy includes the appointment of broad-spectrum antibiotics. Detoxification, anti-inflammatory and antihistamines are prescribed as additional treatment. In the presence of complications, their symptomatic treatment is carried out. Mastoiditis, which has an otogenic nature, is treated surgically.
