Mastoiditis in Adults

The upper part of our face is supported by temporal bone that is found at the base and sides of the skull (lateral to temporal lobes of cerebrum). The posterior section of the temporal bone is constituted by mastoid bone. When mastoid is infected, the condition is termed as mastoiditis.

This infection is an outcome of untreated middle ear infections. Although this infection is more prominent in children, mastoiditis in adults is equally a serious concern.

The middle ear space of a human ear is the place which contains the mastoid bone. Besides, the middle ear is also responsible for distributing the acoustic energy within cochlea of the ear by decompressing the sound waves. The mastoid bone has a honeycomb like structure which gets filled with the infected bacteria.

Chronic mastoiditis in adults is a result of inflammation in the middle ear mastoid bone (located behind the outer ear) which leads to infection in spaces within mastoid. If symptoms are ignored, the infection can spread into the small cavities of the mastoid bone and block the fluid drainage, thereby degenerating the honeycomb structure of the mastoid bone.

In severe cases, mastoiditis can lead to hearing loss and complications like meningitis, brain abscess and labyrinthitis.

The major cause for this infection is acute otitis media (middle ear infection). This ear infection is triggered by bacteria. The honey-comb structure of the mastoid bone becomes inflamed due to unhealthy growth of these micro-organisms and the toxins secreted by them.

Haemophilus influenzae and Streptococcus pneumoniae are responsible for causing ear infections that lead to inflammation in the mastoid bone.

Other bacteria include:

• Pseuodomonas aeruginosa
• Staphylococcus aureus
• Fusobacterium
• Escherichia coli
• Klebsiella
• Prevotella
• Proteus
• Porphyromonas
• Bacteroides

When the mastoid bone is infected, it produces some indications, which help identify the seriousness of the condition. It is essential to identify the signs in the initial stages and administer treatment to prevent this disorder from leading to unwanted complications

• Swelling in tympanic membrane of ear
• Intense pain behind the ear
• Low-grade fever
• Headache
• Thick and purulent fluid draining from ear profusely
• Redness in bone behind ear
• Erythematous

In the absence of timely medical intervention, these symptoms can lead to more ominous ones like;

• Facial paralysis
• Vertigo
• Meningitis
• Lateral sinus thrombosis
• Nerve deafness

Diagnosis always precedes any treatment. CT Scan and MRI are techniques used for diagnosing mastoiditis. A CT scan is a diagnostic imaging procedure that scans the body horizontally and vertically as cross sectional images.

Whereas an MRI uses radio frequencing technique to produce detailed images of organs inside the body. Once the diagnosis of infection in mastoid bone inside ear is confirmed, the treatment starts.

Treating mastoiditis is not an easy procedure. This is because the mastoid bone is located quite deep inside the ear. Treatment is usually long-term till the infection reduces. Antibiotics are administered through injections and orally.

 Following are some of the antibiotics prescribed by doctors for immediate effectiveness of treatment.

• Ticarcillin
• Nafcillin
• Clinda mycin
• Clavulanate
• Ciprofloxacin
• Gentamicin

Please Note:

• The above antibiotics must be taken under doctor's prescription only.
• The course of antibiotic treatment must be completed thoroughly as per doctor's advice.

In conditions, where antibiotic treatments do not show results, surgical means like mastoidectomy, myringotomy and tympanocentesis are adopted.

The infected part of the mastoid bone is removed and drained thoroughly in the surgery. Radical mastoidectomy is done in serious cases where the mastoid bone is chronically inflamed causing loss of hearing.

This procedure involves excision of posterior wall of ear canal, malleus, incus and remnants of tympanic membrane. This treatment is effective in stopping the infection from spreading further into facial nerves and brain. In myringotomy, a small incision is made in the eardrum to relieve excess build up of pressure caused by fluid.

The treatment also aids in draining out accumulated pus. Tympanocentesis procedure involves insertion of a small needle with a tube to drain the excess accumulated fluid caused due to the ear infections.

However, post surgery also, the patient is again put on an oral antibiotic therapy for several weeks until there is no trace of infection manifestation inside ear.

Human ear is an important organ. Apart from the ability to hear, a human ear is also responsible for maintaining the body pressure. Any condition of anomaly within ear is bound to affect the entire system of the body. So if you experience a searing ear pain with continual draining of water, better seek medical attention at the earliest!