Mastoiditis: symptoms, causes & treatment

Most of us have experienced ear pain at some point in our lives. Usually, it’s a minor ear infection that goes away with medicine. However, ear infections can occasionally worsen and impact the bony region directly behind the ear. Even though Mastoiditis isn’t as common these days, thanks to antibiotics, you should be aware of this condition. Why? Well, mastoiditis can cause problems that impact your hearing, balance, and even your general health if left untreated.

This blog post will delve deeper into mastoiditis, including its definition, causes, symptoms in adults and children, diagnosis, and its treatments. 

What is Mastoiditis?

There is a portion of your skull that is situated just behind the ear. This part is called the mastoid bone. Although the mastoid bone appears solid, it is made up of tiny air pockets that protect your ears from sensitive hearing structures. It also helps control ear pressure.

Mastoiditis occurs when an ear infection reaches the bone. It most often starts as a middle ear infection. The infection leads to swelling, redness, and sometimes a pus-filled pocket in the mastoid’s honeycomb-like structure. If left untreated, the infection can damage the bone tissue. It can impair hearing or spread to other parts of the body. In very young children, mastoiditis may even cause death. Typically, 2-year-olds and younger children are most vulnerable. 

Mastoiditis was once life-threatening. Now, we have achieved immense advancement in medicine. A round of antibiotics has made mastoiditis a less common problem. There are even vaccinations to prevent infections. However, it is still important to understand this condition and treat it quickly. Given that children are at a higher risk of developing mastoiditis, it is especially important to understand the condition.

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Types of Mastoiditis

There are two distinct types of mastoiditis, which we will look at in depth later on in the blog. For now, let’s break down the basic understanding of these types:

• Acute mastoiditis: This type typically occurs a few days after an ear infection. It generally goes away with a round of antibiotics, within a month or so. It also rarely recurs.
• Chronic mastoiditis: As the name would suggest, this type is a recurring or longstanding ear infection that leads to mastoiditis. The infection lasts at least a month.

Causes of Mastoiditis

The main cause of mastoiditis is a middle ear infection that isn’t treated properly. The infection spreads to the nearby bone. It is rare for people to develop mastoiditis without a middle ear infection. This rare occurrence is called cholesteatoma, which causes mastoiditis. Cholesteatoma is an abnormal skin growth. It is usually found in your middle ear. The growth blocks the fluid that needs to drain, leading to mastoiditis. Let’s take a closer look at some of these causes:

• Middle Ear Infections: This is the most common cause of mastoiditis. There are trapped bacteria in the middle ear, which cause an infection. If this infection is not treated on time, and the bacteria are not eliminated, they can spread to the mastoid bone.

• Chronic Ear Infections: If you are someone who gets chronic ear infections, recurring multiple times in the span of a short period or lasting longer than normal, you are at an increased risk of developing mastoiditis. This happens because the bacteria that cause the infection have multiple opportunities to reach your mastoid bone.

• Blocked Eustachian Tubes: The eustachian tubes are responsible for draining the fluid from the middle ear. If they are blocked because of allergies, sinus issues, or colds, bacteria can grow and spread to the mastoid bone.

• Compromised Immunity: A compromised immunity increases your risk of infection in any part of the body. Certain demographics, like children or the elderly, are at a higher risk of developing an infection that leads to mastoiditis because of their weakened immune systems. Children’s immune systems are vulnerable because they are not fully developed.

• Bacteria Strains: Some infectious strains of bacteria are stubborn and aggressive. Take, for instance, the Streptococcus pneumoniae or Haemophilus influenzae. These bacteria are more likely to cause mastoiditis. They also require quite an aggressive treatment plan, as they can come back easily.

Mastoiditis Symptoms

Now, mastoiditis can develop over days or even weeks. It starts with a middle ear infection, but that does not mean mastoiditis starts right away. If the infection is not treated in time, the symptoms of mastoiditis begin. These symptoms include:

• Persistent ear pain that does not seem to go away. It might even feel like throbbing pain.
• Swelling or redness behind the ear, where the mastoid bone is located.
• Fever or fatigue
• Drainage of pus or fluid from the affected ear.
• Hearing loss or muffled sounds
• Headaches or general discomfort around the ear
• Protruding ear. The ear will look pushed forward because of the swelling.

Each person may present the symptoms differently. Not everyone will have all the symptoms. Typically, if the ear pain is combined with fever and swelling, it is a good time to seek medical attention immediately.

Mastoiditis Symptoms in Adults

Adult symptoms of mastoiditis are different than those in children. In the case of children, fever and irritability are some of the first signs. In adults, symptoms can look as follows:

• Deep ear pain that worsens at night
• Noticeable hearing changes in the affected ear
• Pressure or fullness in the ear
• Swelling that makes the ear stick out abnormally
• Persistent headaches
• Dizziness or vertigo symptoms due to inner ear involvement

When it comes to children, we tend to pay closer attention and take anything abnormal seriously. Children who get mastoiditis are more likely to be diagnosed earlier than adults. Adults often ignore ear pain, believing it to be just an infection. This causes mastoiditis to go unnoticed longer than is safe. Adults are more prone to complications arising from undiagnosed or untreated mastoiditis. Recognizing the warning signs is crucial.

Acute Mastoiditis vs Chronic Mastoiditis

Similar to many conditions, mastoiditis has certain types. Not everyone who has mastoiditis will be affected in the same way. So, let’s take a look at the two distinct types of mastoiditis.

• Acute Mastoiditis: Acute mastoiditis is a serious condition. It starts with an infection in the middle ear, which travels to the mastoid bone. This type develops quickly, usually within days of an untreated middle ear infection. The symptoms of acute mastoiditis are more severe. There is sharp pain, swelling, fever, hearing loss, and redness behind the ear.

Diagnosis for acute mastoiditis often includes a clinical examination and a CT scan. Treatment for acute mastoiditis includes intravenous antibiotics and, in some cases, surgery. A surgery, or mastoidectomy, ensures there are no severe complications like meningitis or brain abscess. Acute mastoiditis is most commonly seen in children.

• Chronic Mastoiditis: Chronic mastoiditis is a persistent, low-grade infection of the mastoid bone. It commonly develops from a long-term middle ear infection. Symptoms of chronic mastoiditis are generally less severe than acute mastoiditis. It develops over weeks or months after the infection. Symptoms of chronic mastoiditis include persistent or recurrent ear discharge, hearing loss, and sometimes a feeling of fullness in your ear. Treatment for this type of mastoiditis is a round of antibiotics and surgery. The surgery can help clear out infected tissue.

Left Mastoiditis and Right Mastoiditis – What’s the Difference?

There is very little difference between left mastoiditis and right mastoiditis. The location and impact of the symptoms may be the only things that differ. The symptoms will occur on one or the other side, whichever is affected. The affected ear will be noticeably different than the unaffected ear. If your dominant ear, the one you rely on the most, is affected, you might notice the hearing loss more prominently. Mastoiditis can cause dizziness, especially in adults. Since the inner ear is responsible for maintaining balance, whichever ear is affected can cause balance issues. You might be more affected by the dizziness if the affected ear is on the side you naturally rely on more.

Mastoiditis Treatment Options

You require a proper diagnosis for mastoiditis treatment to begin. A doctor will begin by conducting some blood tests. This test can indicate if there is an active infection in your body. Next, they may look at your ear culture. Your doctor will collect the drainage coming from your affected ear and test it for the specific bacteria associated with mastoiditis. The next step is to conduct a CT scan, which will give you a detailed image of the inside of your skull. Your doctors can use this to pinpoint the exact location of the infection. Sometimes, an MRI may be ordered to check the area between the ear and the brain.

Treatment comes next. Doctors often treat mastoiditis with antibiotics and steroids. If the middle ear is not draining the infected fluid, they may perform a myringotomy. The doctor makes a tiny hole in your eardrum and drains the excess fluid trapped behind it. Your doctors may place small tubes in the incision they made to ensure all the fluid is dripping out. Within six months to a year, you can expect the tubes to fall out all on their own.

If there is a pocket of pus in your temporal lobe, your doctor may perform a mastoidectomy to remove the infected bone altogether.

Complications of Untreated Mastoiditis

When mastoiditis, or even the middle ear infection, is left untreated, the infection can spread. It can cause complications like:

• Facial paralysis
• Partial or complete hearing loss
• Inner ear infection
• Meningitis Infection (which is an infection of the tissues covering your brain)
• Swelling in your brain
• Sepsis (which is a life-threatening inflammation throughout your body)

Mastoiditis used to be life-threatening at one point. However, times have changed. Life-threatening complications are far less common nowadays. It’s important that you seek treatment as soon as possible to avoid any complications or long-term issues.

Conclusion

Mastoiditis sounds like a scary condition, and it is in some ways. However, it is also treatable and manageable. Modern medicine has made it possible to treat and reduce the risk of this condition. The key is early detection. If you or someone you know has persistent symptoms, such as ear pain, swelling behind the ear, or fever, it is best to seek medical help immediately. Avoid delaying a diagnosis and treatment. Your ears control many significant functions in your body. So, when it comes to caring for them, it is always better to be safe than sorry.