Mastoiditis is a rare ear-linked condition wherein infection and inflammation occur in the mastoid bone situated behind the ear. The mastoid bone is a vital organelle composed of air sacs with an appearance similar to that of a sponge, unlike other bones that are hardened. It needs to receive air from the other parts of the ear including the eustachian tube, in order to carry out its routine functions of regulating ear pressure and protecting the delicate inner structures of the ear. The mastoid bone also forms a segment of the temporal bone in the skull and safeguards the rigid assembly from damage during trauma. Since the eustachian tube connects the middle ear and the rear portion of the throat, in instances of middle ear infections, it can result in eustachian tube dysfunction and mastoiditis.
Causes Of Mastoiditis:
Mastoiditis chiefly occurs due to bacterial infections of the middle ear that have not been treated properly or completely. This invariably leads to the spread of the pathogenic microbe to the inner ear and mastoid bone, subsequently becoming rather severe and triggering its degradation if not given timely medical care.
Mastoiditis affects either only one ear at a time or both ears simultaneously and though it arises often in children, it can develop in adults as well.
Symptoms And Complications:
The distinct signs associated with mastoiditis are in many ways the same as that of ear infections since mastoiditis primarily arises from serious infectious conditions in the hearing assemblies. These include:
- Ear pain
- Prominent swelling, with redness and irritation behind the affected ear
- Throbbing headaches
- Oozing of liquid discharge from the infected ear
- Hearing loss to a certain extent in the inflamed ear
In very grave situations, mastoiditis can lead to brain abscess with excruciating headaches and swelling at the back of the eyes i.e. papilledema. Furthermore, if not given proper treatment, mastoiditis induces serious health consequences such as dizziness/vertigo, paralysis of the facial area and even an advanced degree of hearing loss.
Upon reporting the symptoms to the doctor, the ears of the patient are thoroughly examined to look for signs of middle ear infections. Since the mastoid bone is seated deep in the internal tissues, it cannot be probed by means of an external exam and hence additional diagnostic evaluations are carried out, such as:
- The white blood cell (WBC) count of the patient is calculated from a blood test, to ascertain the presence of pathogenic bacteria or microbes that trigger infection
- CT scan i.e., computed tomography, to clearly view the internal portions of the ears and head
- MRI scan of the inner ear structures and the segments within the skull, to spot any injured, damaged or inflamed tissues
- X-ray of the skull
- Spinal tap/lumbar puncture, to probe the fluid within the skull to look for signs of infection in the spinal column
Treatment for mastoiditis depends on the duration and severity of symptoms. If only a minor infection is present in the middle ear and is given appropriate medical treatment on time, then it does not affect the eustachian tube and mastoid bone and thus mastoiditis can effectively be prevented. When infection is detected in the mastoid tissues but has not progressed to an alarming degree, then oral antibiotics are prescribed which helps to combat the pathogens and remedy ear infections.
However, in certain circumstances, mastoiditis can be life-threatening with severe complications of swelling behind the ears and at the rear end of the eyes, headaches, dizzy sensations and loss of motion of facial muscles i.e. paralysis. In such serious cases, the patient is admitted to the hospital at once and administered antibiotics intravenously. In addition, surgery may be required entailing an incision and drainage procedure to draw out the infected fluids from the middle ear.
Surgical protocols to remove a part of the mastoid bone that has been damaged and to extract excess fluids with infectious agents from those areas are also performed. In this manner, normal functions of the ears and their internal organelles can be restored to a considerable extent and the patient is advised to continue taking oral antibiotics after being discharged from the hospital.