Mastoiditis (patient information): Difference between revisions
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{{Otitis media (patient information)}} | {{Otitis media (patient information)}} | ||
[[Category:Patient information]] | |||
==Overview== | ==Overview== | ||
Mastoiditis is the infection of [[mastoid air cells]] in the process of [[temporal bone]]. It is mostly a complication of ear diseases such as [[acute otitis media]] and [[chronic otitis media]], and it tends to occur in children. However after developments of [[antibiotics]] [[acute otitis media]] complications have decreased significantly. | |||
==What are the symptoms of | ==What are the symptoms of mastoiditis?== | ||
Otitis media is often difficult to detect because most children affected by this disorder do not yet have sufficient speech and language skills to tell someone what is bothering them. Common signs to look for are: | Otitis media is often difficult to detect because most children affected by this disorder do not yet have sufficient speech and language skills to tell someone what is bothering them. Common signs to look for are: | ||
* | * Recent episode of ear infection | ||
*Ear pain and posterior ear pain | |||
*Unusual [[irritability]] | *Unusual [[irritability]] | ||
*Difficulty [[sleep]]ing | *Difficulty [[sleep]]ing | ||
| Line 86: | Line 24: | ||
*Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive | *Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive | ||
*Clumsiness and poor balance | *Clumsiness and poor balance | ||
*[[Headache]] | |||
*[[Lethargy]] | |||
*[[Common cold]] symptoms | *[[Common cold]] symptoms | ||
==What causes | ==What causes mastoiditis?== | ||
Anything that causes the [[Eustachian tube|eustachian tubes]] in the [[middle ear]] to become swollen or blocked causes more fluids to build up in the middle ear behind the eardrum | Anything that causes the [[Eustachian tube|eustachian tubes]] in the [[middle ear]] to become swollen or blocked causes more fluids to build up in the middle ear behind the eardrum and then mastoid bone may be involved These causes. include: | ||
* [[Allergies]] | * [[Allergies]] | ||
* [[Common cold|Colds]] and [[Sinus infection|sinus infections]] | * [[Common cold|Colds]] and [[Sinus infection|sinus infections]] | ||
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Risk factors for ear infections include the following: | Risk factors for ear infections include the following: | ||
* Attending daycare | * Attending daycare | ||
* Changes in altitude or climate | * Changes in altitude or climate | ||
* Cold climate | * Cold climate | ||
| Line 116: | Line 56: | ||
==Diagnosis== | ==Diagnosis== | ||
*The simplest way to detect an active infection in the middle ear is to look in the child's ear with an [[otoscope]], a light instrument that allows the physician to examine the [[outer ear]] and the [[eardrum]] | *Posterior ear inflammation and redness in physical examination | ||
*The simplest way to detect an active infection in the middle ear is to look in the child's ear with an [[otoscope]], a light instrument that allows the physician to examine the [[outer ear]] and the [[eardrum]]. | |||
*There are several ways that a physician checks for middle ear fluid: | *There are several ways that a physician checks for middle ear fluid: | ||
**The use of a special type of otoscope called a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement. | **The use of a special type of otoscope called a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement. | ||
***An eardrum with fluid behind it does not move as well as an eardrum with air behind it. | ***An eardrum with fluid behind it does not move as well as an eardrum with air behind it. | ||
**[[Tympanometry]] is a test requiring insertion of a small soft plug into the opening of the child's ear canal, providing information indicative of hearing loss from middle ear congestion. | **[[Tympanometry]] is a test requiring insertion of a small soft plug into the opening of the child's ear canal, providing information indicative of hearing loss from middle ear congestion. | ||
* Physician may use CT scan in order to detect complications. | |||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
Call your child's doctor if: | Call your child's doctor if: | ||
*[[Pain]], [[fever]], or [[irritability]] do not improve within 24 to 48 hours | *[[Pain]], [[fever]], or [[irritability]] do not improve within 24 to 48 hours with antibiotic therapy | ||
*At the start, the child seems sicker than just an ear infection | *At the start, the child seems sicker than just an ear infection | ||
*Your child has a high fever or severe pain | *Your child has a high fever or severe pain | ||
| Line 141: | Line 83: | ||
*If a child is experiencing pain, the physician may also recommend a pain reliever, such as [[tylenol]]. | *If a child is experiencing pain, the physician may also recommend a pain reliever, such as [[tylenol]]. | ||
*Following the physician's instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared. | *Following the physician's instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared. | ||
*A surgical procedure called a [[myringotomy]] | *A surgical procedure called a [[myringotomy]] should be performed in mastoiditis patients. | ||
**While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum. | **While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum. | ||
* In some patients a device called tempanestomy tube may be used. | |||
**A small metal or plastic tube is placed into the opening in the eardrum, ventilating the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment. | **A small metal or plastic tube is placed into the opening in the eardrum, ventilating the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment. | ||
**The tube normally stays in the eardrum for 6 to 12 months, after which it usually comes out spontaneously. | **The tube normally stays in the eardrum for 6 to 12 months, after which it usually comes out spontaneously. | ||
** | **Remove of mastoid bone may be done in selective patients. | ||
==Where to find medical care for | ==Where to find medical care for mastoiditis?== | ||
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Otitis media}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating | [http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Otitis media}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating mastoiditis] | ||
==Prevention== | ==Prevention== | ||
*Prevention of | *Prevention of mastoiditis is contingent upon preventing exposure to the cause, including the following: | ||
**[[Bacteria]] and [[viruses]] responsible for [[middle ear infection]], such as [[common cold]]. | **[[Bacteria]] and [[viruses]] responsible for [[middle ear infection]], such as [[common cold]]. | ||
***Vaccinations include ''[[pneumococcal]]'' and [[influenza]]. | ***Vaccinations include ''[[pneumococcal]]'' and [[influenza]]. | ||
| Line 161: | Line 105: | ||
**Breastfeeding infants up to 6 months old to help develop their immune systems. | **Breastfeeding infants up to 6 months old to help develop their immune systems. | ||
**Antibiotic regimens for children that have high risk for otitis media. | **Antibiotic regimens for children that have high risk for otitis media. | ||
**Completion of prescribed antibiotics for patients. | |||
==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
* | * Without treatment, [[mastoiditis]] will result in sever complications such as intracranial extension and permanent neurological deficits or death. The consequences of [[mastoiditis]] have been reduced after introduction of antimicrobial agents and adequate therapy of [[acute otitis media]]. However [[mastoiditis]] has not been eradicated completely and may give rise to sever complications | ||
*Complications from mastoiditis, including [[meningitis]] and bone and brain abscesses (infections of the brain and bones around the skull) can lead to poor prognosis without treatment. | |||
*Complications from | *Untreated mastoiditis may lead to permanent hearing impairment due to persistent fluid in the middle ear reducing a child's hearing. | ||
*Untreated | |||
**Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities. | **Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities. | ||
==Possible complications== | ==Possible complications== | ||
*Complications include spread of infection outside of the middle ear | *Complications include spread of infection outside of the middle ear | ||
** | **Bone and brain abscesses | ||
**[[Meningitis]] | **[[Meningitis]] | ||
*Other potential complications include the following: | *Other potential complications include the following: | ||
| Line 183: | Line 127: | ||
==Sources== | ==Sources== | ||
http://www.nlm.nih.gov/medlineplus/earinfections.html | http://www.nlm.nih.gov/medlineplus/earinfections.html | ||
[[Category:Patient information]] | [[Category:Patient information]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
| Line 192: | Line 135: | ||
[[Category:Otology]] | [[Category:Otology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Revision as of 16:18, 3 July 2017
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Mastoiditis Microchapters |
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For the WikiDoc page for this topic, click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]
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Otitis media (Ear Infection) |
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Otitis media On the Web |
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Overview
Mastoiditis is the infection of mastoid air cells in the process of temporal bone. It is mostly a complication of ear diseases such as acute otitis media and chronic otitis media, and it tends to occur in children. However after developments of antibiotics acute otitis media complications have decreased significantly.
What are the symptoms of mastoiditis?
Otitis media is often difficult to detect because most children affected by this disorder do not yet have sufficient speech and language skills to tell someone what is bothering them. Common signs to look for are:
- Recent episode of ear infection
- Ear pain and posterior ear pain
- Unusual irritability
- Difficulty sleeping
- Tugging or pulling at one or both ears
- Fever
- Fluid draining from the ear
- Loss of balance
- Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive
- Clumsiness and poor balance
- Headache
- Lethargy
- Common cold symptoms
What causes mastoiditis?
Anything that causes the eustachian tubes in the middle ear to become swollen or blocked causes more fluids to build up in the middle ear behind the eardrum and then mastoid bone may be involved These causes. include:
- Allergies
- Colds and sinus infections
- Excess mucus and saliva produced during teething
- Infected or overgrown adenoids
- Tobacco smoke or other irritants
Risk factors for ear infections include the following:
- Attending daycare
- Changes in altitude or climate
- Cold climate
- Exposure to smoke
- Genetic factors (susceptibility to infection may run in families)
- Not being breastfed
- Pacifier use
- Recent ear infection
- Recent illness of any type (lowers resistance of the body to infection)
Who is at highest risk?
- Infants and young children are especially susceptible to ear infections:
- Immune systems are not fully developed.
- Smaller and straighter eustachian tubes are more prone to clogging.
- Larger adenoids interfering with eustachian tube openings.
- Close proximity with other infants and young children in settings such as schools or daycares, etc.
- Those with consistent exposure to air pollution, such as secondhand smoke.
Diagnosis
- Posterior ear inflammation and redness in physical examination
- The simplest way to detect an active infection in the middle ear is to look in the child's ear with an otoscope, a light instrument that allows the physician to examine the outer ear and the eardrum.
- There are several ways that a physician checks for middle ear fluid:
- The use of a special type of otoscope called a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement.
- An eardrum with fluid behind it does not move as well as an eardrum with air behind it.
- Tympanometry is a test requiring insertion of a small soft plug into the opening of the child's ear canal, providing information indicative of hearing loss from middle ear congestion.
- The use of a special type of otoscope called a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement.
- Physician may use CT scan in order to detect complications.
When to seek urgent medical care?
Call your child's doctor if:
- Pain, fever, or irritability do not improve within 24 to 48 hours with antibiotic therapy
- At the start, the child seems sicker than just an ear infection
- Your child has a high fever or severe pain
- Severe pain suddenly stops hurting -- this may indicate a ruptured eardrum
- Symptoms worsen
- New symptoms appear, especially severe headache, dizziness, swelling around the ear, or twitching of the face muscles
For a child younger than 6 months, let the doctor know right away if the child has a fever, even if no other symptoms are present.
Treatment options
- Many physicians recommend the use of an antibiotics when there is an active middle ear infection to kill the causative bacteria.
- Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
- Several different antibiotics may have to be tried before an ear infection clears due to possibility of the bacteria developing resistance to the antibiotics.
- If a child is experiencing pain, the physician may also recommend a pain reliever, such as tylenol.
- Following the physician's instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
- A surgical procedure called a myringotomy should be performed in mastoiditis patients.
- While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum.
- In some patients a device called tempanestomy tube may be used.
- A small metal or plastic tube is placed into the opening in the eardrum, ventilating the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment.
- The tube normally stays in the eardrum for 6 to 12 months, after which it usually comes out spontaneously.
- Remove of mastoid bone may be done in selective patients.
Where to find medical care for mastoiditis?
Directions to Hospitals Treating mastoiditis
Prevention
- Prevention of mastoiditis is contingent upon preventing exposure to the cause, including the following:
- Bacteria and viruses responsible for middle ear infection, such as common cold.
- Vaccinations include pneumococcal and influenza.
- Washing hands frequently.
- Avoiding common cold patients.
- Limiting child enrollment in daycare.
- Avoiding pacifiers for infants.
- Limiting exposure to air pollution, such as secondhand smoke.
- Breastfeeding infants up to 6 months old to help develop their immune systems.
- Antibiotic regimens for children that have high risk for otitis media.
- Completion of prescribed antibiotics for patients.
- Bacteria and viruses responsible for middle ear infection, such as common cold.
What to expect (Outlook/Prognosis)?
- Without treatment, mastoiditis will result in sever complications such as intracranial extension and permanent neurological deficits or death. The consequences of mastoiditis have been reduced after introduction of antimicrobial agents and adequate therapy of acute otitis media. However mastoiditis has not been eradicated completely and may give rise to sever complications
- Complications from mastoiditis, including meningitis and bone and brain abscesses (infections of the brain and bones around the skull) can lead to poor prognosis without treatment.
- Untreated mastoiditis may lead to permanent hearing impairment due to persistent fluid in the middle ear reducing a child's hearing.
- Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities.
Possible complications
- Complications include spread of infection outside of the middle ear
- Bone and brain abscesses
- Meningitis
- Other potential complications include the following:
- Ruptured or perforated eardrum.
- Chronic, recurrent ear infections.
- Enlarged adenoids or tonsils.
- Formation of an abscess or a cyst (called cholesteatoma) from chronic, recurrent ear infections.
- Speech or language delay in a child who suffers lasting hearing loss from multiple, recurrent ear infections.