Acute mastoiditis lecture

ENT - BBH

ACUTE MASTOIDITIS

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DEFINITION

It is the inflammation of mucosal lining of antrum and mastoid air cells system.

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Etiology

Age

Socio economic group

Organism virulence

Immunocompromised

Cholesteatoma

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Pathology

Production of pus under tension

Hyperaemic decalcification

Osteoclastic resorption of bony walls

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ROUTES OF SPREAD

Direct bone erosion

Venous thrombophlebitis

Petrosquamous suture

Oval or round windows

Internal auditory meatus

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Clinical Features

Symptoms:

Earache

Fever

Ear discharge

Signs:

Mastoid tenderness

Sagging of posterosuperior meatal wall

TM perforation

Swelling over mastoid

Hearing loss

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Investigations

Blood CP

X-ray mastoids

CT scan temporal bones

Ear swab for c/s

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Differential Diagnosis

Suppuration of mastoid lymph nodes

Furunculosis of meatus

Infected Sebaceous cyst

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TREATMENT

Medical treatment

Hospitalize

Antibiotics

Analgesics

Surgical treatment

Myringotomy

Cortical mastoidectomy

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COMPLICATIONS

Subperiosteal abscess

Labyrinthitis

Facial paralysis

Petrositis

Extradual abscess

Subdural abscess

Meningitis

Brain abscess

Lateral sinus thrombophlebitis

Otitic hydrocephalus

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Post-auricular abscess

Zygomatic abscess

Bezold abscess

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MASKED (LATENT) MASTOIDITIS

Slow destruction of mastoid air cells

No pain, discharge, fever, mastoid swelling

Mastoidectomy shows extensive destruction of air cells with granulation tissue

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