La mastoiditis It is an inflammation or infection of the mastoid bone, a part of the temporal bone, located behind the ear.
This infection can occur as a result of extension of middle ear inflammation to the mastoid cells (often by a acute otitis media).
Mastoiditis is usually affects children and, thanks to the specific antibiotics, today it is relatively rare and less dangerous.
Symptoms usually appear two or more weeks after the development of acute otitis media, as the disseminated infection destroys the inner part of the mastoid process. A lump may form abscess on the bone. The skin overlying the mastoid bone may become red, swollen, and painful, and the outer ear moves to the side and down.
- Secretion of the ear.
- Pain or ear discomfort.
- Fever which may be high or increase suddenly.
- Headache.
- Redness of the ear or behind it.
- Swelling behind the ear.
The symptoms of mastoiditis may resemble other conditions or medical problems. If you experience any of these symptoms, check with the doctor.
Ear prevention and care
To avoid serious infections such as mastoiditis, it is necessary treat and cure properly All ear problems, especially otitis media or recurrent ear infections. It's also advisable to follow a series of guidelines for ear hygiene and protection:
- To keep your ears clean, simply pass the peak of a towel or a moistened gauze over the earlobe, without rubbing and without forgetting the folds behind the ears.
- The inner area of ​​the ear should not be cleaned with cotton swabs nor should they be inserted into the ear canal under any circumstances, as they can cause injury to the area and/or cause inflammation.
- La wax It will come out of your ears on its own; you should not try to get it out with anything.
- Dry his ears well after bathing him and cover his ears when you go out for a walk in winter.
- You can use a seawater diffuser o physiological serum that allows you to gently and safely clean both the outer and inner ears. Continued use of these diffusers prevents hearing problems, such as earwax, and keeps your ears healthy.
- Avoid the loud noises and very loud television or music, their hearing is more acute and sensitive than that of older people and could damage them; consider using plugs adequate.
- It agrees do not keep the baby's ears underwater, but nothing happens if they get splashed or get a little bit in them.
- If the child has an ear infection it is better to do not fly by plane, since the Eustachian tubes are not yet functioning perfectly and the higher air pressure will exert force on one side of the eardrum, causing pain.
- Even if there is no infection, when flying the child will feel more pressure than an adult, so it is recommended that when landing and taking off chew gum or candy, drink water or use a pacifier.
What is mastoiditis and the most common types
La mastoiditis It is the infection of the air cells of the mastoid bone connected to the middle ear. It may be acute (appears after otitis media), chronicle (persistent or recurrent, with progressive damage) or present in a masked, with less obvious symptoms. In cases called coalescents The bony septa are destroyed and an empyema forms within the mastoid.
Causes and risk factors
The most common cause is acute otitis media that spreads to the mastoid. The most commonly implicated pathogens are Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and, in specific contexts, Staphylococcus aureus o Pseudomonas aeruginosa. They predispose the recurrence of otitis media, the immunosuppression, childhood age due to anatomical characteristics of the Eustachian tube and situations like the cholesteatoma in chronic middle ear pathology.
Diagnosis: How it is confirmed
The diagnosis begins with the clinic history (recent history of otitis media) and the Physical exam of the ear and mastoid region: pain on palpation, redness, swelling and deviation of the flag. The otoscopy may show bulging or perforated tympanic membrane with otorrhea.
The imaging tests help confirm bone involvement and rule out complications: CT scan of the ear and, if necessary, the head. Plain skull X-rays are less sensitive. When there is discharge, it is recommended sampling for cultivation (ideally deep and by aspiration) to direct the antibiotic and minimize contamination.
In uncomplicated mastoiditis with good clinical evolution, the specialist may decide do not make input image and monitor closely.
Treatment and care
Mastoiditis is treated with broad spectrum antibiotics by way intravenous initially, followed by pattern oral administration when there is improvement. Drugs active against pneumococcus and other common pathogens are used (e.g., ceftriaxone o cefotaxime), valuing Amoxicillin clavulanic or the addition of vancomycin if suspected S. aureus resistant, and metronidazol if anaerobes are suspected. Treatment may be prolonged due to the difficult penetration of the antibiotic in the bone.
In the presence of abscess or poor response, may be required myringotomy (drainage through the eardrum) and, in severe or complicated cases, mastoidectomy to remove infected tissue. In uncomplicated cases and stable patients, some teams consider management ambulatory with intramuscular ceftriaxone and clinical review in 24 hours.
In addition, it is recommended analgesia y antipyretics, keep hydration, do not manipulate the ear canal with cotton swabs and avoid antibiotic self-medicationHome remedies can relieve pain, but they do not cure mastoid infection.
Complications and warning signs
Without treatment or with unfavorable evolution, they may appear bone destruction of the mastoid, subperiosteal abscess, epidural abscess, meningitis, sigmoid sinus thrombosis, labyrinthitis with vertigo, Facial paralysis y hearing loss partial or complete, which may impact the language development. In view of persistent fever, severe pain behind the ear, progressive inflammation, purulent discharge, vomiting, severe dizziness or any neurological symptoms should be sought immediate medical attention.
With early diagnosis, appropriate antibiotics and drainage when indicated, mastoiditis is curable; however, it may reappear if risk factors or middle ear infections persist.
Mastoiditis is rare today, but requires early detection, targeted treatment and a good plan prevention of otitisIdentifying warning signs, following ear hygiene recommendations, and consulting a specialist if you have any questions are key to protecting your hearing and avoiding complications.