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Everything you need to know about mastoiditis

Mastoiditis results from bacterial infections of the air cells in the mastoid bones. They rarely get severe nowadays and can usually be treated conservatively. However, in severe cases, surgery is necessary to prevent complications. Let us learn more about the condition, its causes, signs, etc.

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Table Of Index

What is mastoiditis?

How is mastoiditis caused?

Risks & Complications

When to consult a doctor ?

Questions to ask your doctor .

Treatment options & cost

Insurance coverage

Long term outlook of the treatment

What is mastoiditis?

Mastoiditis is the infection of the mastoid bone. The mastoid bone is located just behind the ear and has many air cavities that protect the delicate structures of the ear, regulate ear pressure, and protect the temporal bone during trauma.
During mastoiditis, these air cavities are infected and filled with discharge. Nowadays, severe mastoid infections are rare as they can be easily treated via antibiotics. However, in rare cases, if the patient has a severe untreated or antibiotic-resistant ear infection, they can get mastoiditis.

How is mastoiditis caused?

Mastoiditis generally results from middle ear infections. Sometimes, if the infection is too severe or recurring, or if the patient is not diligent about following their treatment course, it can spread to the mastoid bone.
In some cases, this infection can even result in the growth of a cholesteatoma, a benign cyst that invades the middle ear and mastoid, leading to further deterioration of the ear canal and permanent hearing loss.

Types of Mastoiditis

Acute mastoiditis

Chronic mastoiditis

Causes

Middle ear infections (acute otitis media)

Cholesteatoma

Symptoms

Fever

Headache

Hearing loss

Redness, swelling, and tenderness behind the ear

Drainage from the ear

Bulging and drooping of the ear

Diagnosis

It is easy to self-assess for mastoiditis. If you (or your child) have a high fever, redness and swelling behind the ear, and severe earache, there is a high chance that you may have mastoiditis.

The following diagnostic tests usually confirm mastoiditis:

Lab culture of the ear discharge
Blood tests like WBC count, CBC, etc.
CT scan of the ear
Head CT scan
X-ray of the skull

The culture helps identify the causing organism behind the ear infection, while the imaging and blood tests help the surgeon ascertain if there is any degeneration in the mastoid bone, along with the severity of the conditions, and helps them formulate the right treatment plan.

In severe cases, if there is a sign that the infection has spread to the skull and brain, you may also need a lumbar puncture (or spinal tap) for diagnosis.

Risks & Complications

If left untreated or improperly treated, mastoid infections can spread to other parts of the body and result in severe complications such as:

Destruction of the mastoid bone
Dizziness and vertigo
Vision changes
Facial paralysis
Meningitis
Epidural abscess
Irreversible partial or total hearing loss
Sepsis, i.e., the spread of infection throughout the body, etc.

Prevention
Mastoid infections usually occur in children due to improper management of initial ear infections. You can prevent mastoid infections by:
- Take medicines for your ear infections as prescribed. If you skip any dose of your antibiotics, it will make it easier for the infection to return in the future.
- Do not self-medicate. If you take medications on your own without a proper prescription from your doctor, you may end up with antibiotic-resistant infections in the future.
- Eat a balanced diet and follow a hygienic lifestyle to avoid recurring ear infections.

When to consult a doctor ?

You should consult a doctor immediately after having a fever or earache. You can visit your regular physician, who will recommend an ENT consultation to you if needed. Any delay in getting proper treatment can result in further complications, therefore, you should seek immediate treatment if you have any issues.

For mastoiditis, you should seek an ENT specialist if:

your ear infection is not responding to treatment,
there is no improvement in your symptoms, or
you have a large swelling behind your ear.

Our mastoiditis Specialist

Questions to ask your doctor .

When would I need surgery for treatment?

Will I be hospitalized after surgery?

How long will it take for me to recover after surgery?

Will I need bed rest after the surgery?

Can mastoiditis recur even after surgery?

Does cholesteatoma always form after mastoidectomy?

Treatment options & cost

Generally, mastoid infections are treated through conservative treatments. The most prevalent treatment for acute mastoid infections is antibiotic treatment. Your ENT doctor can prescribe you antigen-specific antibiotics for better results.

In case you are not benefited from conservative management, your doctor may recommend surgical intervention to you. The first line of surgery is drainage of ear discharge through a myringotomy. If there is no improvement even then, you may need mastoidectomy surgery. During mastoidectomy, the surgeon will create an incision behind the ear and remove the diseased parts of the mastoid bone.

Insurance coverage

Most major health insurance providers cover mastoidectomy surgery, however, the extent of the coverage depends on the policy terms. Generally, the surgery is covered as a daycare procedure, and insurance providers do not provide coverage for an overnight hospital stay. If you are unsure about your policy terms, you can consult your insurance provider.

Pristyn Care also has an expert insurance team that will help you file a claim for insurance coverage, helps you understand your policy terms, and helps you get reimbursement for medicines and diagnostic tests you have paid out-of-pocket for.

Long-term-outlook-of mastoiditis treatment

Long term outlook of the treatment

Ear infections are a very common health problem, especially during childhood. If you or your child had an ear infection that had progressed to mastoiditis, then it is very likely that you may have needed surgical intervention.

Mastoidectomy surgery has proven to be successful in over 85-90% cases and is associated with very low recurrence rates. To ensure this, you need to take proper care of yourself after the surgery and follow your ENT surgeon’s directions explicitly.

FAQ

What is silent mastoiditis?

Silent mastoiditis is a severe form of mastoiditis in which the mastoid bone degenerates without any outward signs like swelling, ear discharge, etc. It is more harmful than mastoiditis in general as it can cause severe damage before the patient notices it and gets treatment.

Can I get mastoiditis even without an ear infection?

Yes, however, it is very uncommon for a patient to have mastoiditis without a coinciding ear infection, as the mastoid bone lies right next to the ear canal, and infection in one part can easily spread to the other.

How often will mastoiditis recur after treatment?

The recurrence rate of mastoiditis after treatment depends on the severity of the condition and the type of treatment. The recurrence rate is generally high after conservative treatments, but after surgical treatments, the infection usually doesn’t come back.

Is mastoiditis a life-threatening issue?

Yes, mastoiditis is a potentially life-threatening issue as the infection can easily spread to the skull, brain, and rest of the body leading to severe complications like meningitis, epidural abscess, sepsis, etc. If you have mastoiditis, you should seek proper treatment immediately.

Can stress lead to mastoiditis?

Yes, stress can lower the body’s inherent immune capacity and increase the chances of ear infections. If you are constantly stressed, then you may suffer from recurring infections as well.

Can a general physician treat mastoiditis?

While you can consult a general physician for acute ear infections you severe or recurring ear infections, including mastoiditis, you should consult an ENT specialist for long-term relief without any complications.

Facts and figures regarding mastoiditis

Though mastoiditis can occur at any age, it most commonly occurs in children below 2 years of age, with a median age of occurrence equaling 12 months.
Less than 0.002% of children with acute otitis media get mastoiditis if they receive proper treatment through antibiotics.
Most cases of mastoiditis occur due to severe ear infections progressing into the mastoid bone.
In severe cases where the mastoid bone has degenerated too much, the patient may need to get part of the ear canal resected as well, which may lead to some degree of irreversible hearing loss.
The most common pathogen in mastoiditis is streptococcal pneumonia, followed by other bacteria like S. aureus, S. pyogenes, H. influenzae, etc.
Mastoiditis usually only occurs in patients with:
- less than 2 years of age
- immunocompromised state
- recurrent ear infections
- incomplete pneumatization of the process, etc.