From WikiLectures

This is an inflammatory disease of the sockets of the mastoid process of the temporal bone . It most often arises as a complication of otitis media . The infection moves from the mucous membrane of the mastoid process to the bony partitions with their subsequent melting ( coalescence = melting, hence coalescent mastoiditis ). Rarely, the infection can spread to this location hematogenously or traumatically.

Forms[edit | edit source]

We distinguish 3 basic forms of mastoiditis:

  1. acute (occurs 2-4 weeks after mesotitis, accounts for approximately 50% of all mastoiditis);
  2. subacute (usually occurs as part of latent otitis media);
  3. latent (also as part of latent otitis media).
Diagram of skull bones. The mastoid process is shown in red.
Diagram of skull bones. The mastoid process is shown in red.

Clinical signs[edit | edit source]

  • Acute mastoiditis : fever , palpation soreness, retroauricular leakage, protruding pinna, purulent discharge from the ear canal, worsening of hypacus, tinnitus , osteoclastic bone destruction;
  • Subacute and latent mastoiditis (symptoms are less pronounced): vague soreness - rather a feeling of pressure in the ear, modest exudation, profuse proliferation of granulation tissue filling the sockets, the bone reacts rather osteoplastically, the septa thicken and sclerotize.

Diagnostics[edit | edit source]

  • History , physical examination (see symptoms);
  • Otoscopy - the image indicates some form of otitis media ;
  • X-ray (projection according to Schüller) – obscuration and disintegration of the pneumatic system;
  • CT.

Differential diagnosis[edit | edit source]

  • Circumscribed external otitis with retroauricular infiltration;
  • Dermatitis in the ear with subsequent retroauricular lymphadenitis;
  • Palpable soreness can be caused by vertebral irritation of the nervus occipitalis minor .

Complications[edit | edit source]

Subperiosteal abscess as a complication of mastoiditis
Subperiosteal abscess as a complication of mastoiditis

Complications of mastoiditis arise from the possibility of infection spreading . It is about:

  • mastoid fistula ;
  • subperiosteal, Mouret's (under the attachment of the digastricus muscle ) or Bezold's (under the attachment of the sternocleidomastoid muscle ) abscess ;
  • thrombophlebitis (by extension of the inflammation medially to the sphincter );
  • infectious disease of the brain or cerebellum .

Therapy[edit | edit source]

  • ATB ;
  • antromastoidectomy .

Links[edit | edit source]

Source[edit | edit source]

References[edit | edit source]

  • KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. edition. Praha : Galén, 2005. 224 pp. ISBN 80-7262-346-X.
  • VOKURKA, Martin – HUGO, Jan, et al. Velký lékařský slovník. 8. edition. Praha : Maxdorf, 2009. 1144 pp. ISBN 978-80-7345-166-0.