Mastoiditis
Mastoiditis is an infection of the mastoid bone of the skull. The mastoid bone is located just behind the ear.
Causes
Mastoiditis is most often caused by a middle ear infection (acute otitis media). The infection may spread from the ear to the mastoid bone. This bone has a honeycomb-like structure that fills with infected material and may break down.
Acute otitis media
Suspected ear infections are one of the most common reasons parents take their children to their health care provider. The most common type of ear i...
The condition is most common in children. Before antibiotics, mastoiditis was one of the leading causes of death in children. The condition does not occur very often today. It is also much less dangerous.
Symptoms
Symptoms include:
- Drainage from the ear
Drainage from the ear
Ear discharge is drainage of blood, ear wax, pus, or fluid from the ear.
ImageRead Article Now Book Mark Article - Ear pain or discomfort
Ear pain or discomfort
An earache is a sharp, dull, or burning pain in one or both ears. The pain may last a short time or be ongoing. Related conditions include:Otitis m...
ImageRead Article Now Book Mark Article - Fever, may be high or suddenly increase
- Headache
- Hearing loss
- Redness of the ear or behind the ear
- Swelling behind the ear, may cause ear to stick out or feel as if it is filled with fluid
Exams and Tests
An exam of the head may reveal signs of mastoiditis. The following tests may show an abnormality of the mastoid bone:
- CT scan of the ear
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
ImageRead Article Now Book Mark ArticleCT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
ImageRead Article Now Book Mark Article - Head CT scan
- Head MRI scan
A culture of drainage from the ear may show bacteria.
Treatment
Mastoiditis may be hard to treat because the medicine may not reach deeply into the bone. The condition sometimes requires repeated or long-term treatment. The infection is treated with antibiotic injections, followed by antibiotics taken by mouth.
Surgery to remove part of the bone and drain the mastoid (mastoidectomy) may be needed if antibiotic treatment does not work. Surgery to drain the middle ear through the eardrum (myringotomy) may be needed to treat the middle ear infection.
Myringotomy
Ear tube insertion involves placing tubes through the eardrums. The eardrum is the thin layer of tissue that separates the outer and middle ear. No...
Outlook (Prognosis)
Mastoiditis can be cured. However, it may be hard to treat and may come back.
Possible Complications
Complications may include:
- Destruction of the mastoid bone
- Dizziness or vertigo
Dizziness
Dizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...
ImageRead Article Now Book Mark Article - Epidural abscess
- Facial paralysis
- Meningitis
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
ImageRead Article Now Book Mark Article - Partial or complete hearing loss
Hearing loss
Hearing loss is being partly or totally unable to hear sound in one or both ears.
ImageRead Article Now Book Mark Article - Spread of infection to the brain or throughout the body
When to Contact a Medical Professional
Contact your health care provider if you have symptoms of mastoiditis.
Also call if:
- You have an ear infection that does not respond to treatment or is followed by new symptoms.
Ear infection
Otitis is a term for infection or inflammation of the ear.
ImageRead Article Now Book Mark Article - Your symptoms do not respond to treatment.
- You notice any facial asymmetry.
Prevention
Prompt and thorough treatment of ear infections reduces the risk for mastoiditis.
Reviewed By
Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Matlock AG, Pfaff JA. Otolaryngology. Matlock AG, In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 58.
Pelton SI. Otitis externa, otitis media, and mastoiditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 61.
