Mastoiditis natural history, complications and prognosis
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Mastoiditis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Natural History, Complications and Prognosis
Although the incidence of clinically significant mastoiditis has decreased since the introduction of antimicrobial agents [2], it has not been eliminated altogether and may still lead to significant and life-threatening complications, such as abscess formation, venous sinus thrombophlebitis, cranial nerve paralysis, meningitis, and osteomyelitis of the temporal bone [1]. The reported incidence of mastoiditis complications ranges from 4% to 16.6%, depending on the specific definition used in the various studies [3–10].
Clinical, laboratory, and microbiological differences between children with simple or complicated mastoiditis Efraim Bilavsky a, *, Havatzelet Yarden-Bilavsky b
Prognosis
With prompt treatment, it is possible to cure mastoiditis. Seeking medical care early is important. However, it is difficult for antibiotics to penetrate to the interior of the mastoid process and so it may not be easy to cure the infection; it also may recur. Mastoiditis has many possible complications, all connected to the infection spreading to surrounding structures. Hearing loss may result, or inflammation of the labyrinth of the inner ear (labyrinthitis) may occur, producing vertigo. The infection may also spread to the facial nerve (cranial nerve VII), causing facial-nerve palsy which can produce weakness or paralysis of some facial muscles on that side of the face. Other complications include Bezold's abscess, an abscess (a collection of pus surrounded by inflamed tissue) behind the sternocleidomastoid muscle in the neck, or a subperiosteal abscess, between the periosteum and mastoid bone ( resulting in the typical appearance of a protruding ear). Serious complications result if the infection spreads to the brain. These include meningitis (inflammation of the protective membranes surrounding the brain), epidural abscess (abscess between the skull and outer membrane of the brain), dural venous thrombophlebitis (inflammation of the venous structures of the brain), or brain abscess.