Mastoiditis

Mastoiditis typically develops when an infection spreads from the middle to the mastoid air spaces of the temporal bone.

Features

• otalgia: severe, classically behind the ear
• there may be a history of recurrent otitis media
• fever
• the patient is typically very unwell
• swelling, erythema and tenderness over the mastoid process
• the external ear may protrude forwards
• ear discharge may be present if the eardrum has perforated

The diagnosis is typically clinical although a CT may be ordered complications are suspected.

Management

• IV antibiotics

Complications

• facial nerve palsy
• hearing loss
• meningitis