What is Mastoiditis?

Mastoiditis is a bacterial infection that affects the mastoid, a delicate bone behind the ear and is the rarest of all ear infections. Its structure is similar to that of a honeycomb, helping to maintain air space in the middle ear. When it becomes infected or inflamed, the porous bone begins to break down, causing visible swelling.

The infection normally occurs as a result of a persistent middle ear infection, and can spread outside of the mastoid bone, causing multiple complications if you do not deal with it quickly. The infection is most common in children, although as an adult, you can be affected too. If you or your child has recently suffered from a middle ear infection, take note of your doctor's advice and recovery recommendations to minimise the risks of developing mastoiditis.

Symptoms

The symptoms can share similar signs to other ear infections, but with an increased visibility of evidence. It’s important to be aware of the warning signs:

  • Fever
  • Irritability
  • Lethargy
  • Swelling behind your ear
  • Redness and tenderness of your ear
  • Ear discharge
  • A middle ear infection that seemingly hasn't gone away

 

Causes

Mastoiditis normally develops after a middle ear infection, where bacteria from the middle ear travels into the air cells of the mastoid bone. However, it can also be caused by cholesteatoma, an abnormal collection of skin cells in the middle ear that can cause extensive inflammation and spread of infection to the mastoid.

Diagnosis

If you suspect that you might have developed mastoiditis, we highly recommend that you seek the advice of a doctor as soon as possible. They will invite you for an initial ear examination, where they will look inside your ear to evaluate your ear's function and check for any inflammation. If they suspect you have an infection, they may recommend further tests to confirm the diagnosis, which may include x-rays, blood tests and swabbed ear-fluid cultures. If your infection is thought to be severe, you may also be sent for a CT or MRI scan.

In rare cases, it can develop into meningitis when the lining of your brain becomes inflamed.

Treatment

Once your local GP has diagnosed the condition you are likely to be prescribed oral antibiotics, eardrops or regular cleaning of the ear. For cases of acute mastoiditis, treatment may take place in your local hospital, where antibiotics will be administered by an IV drip.

Surgery is also an option, removing the mastoid bone completely or draining your ear. Ear draining is known as a myringotomy, and works by making a small hole in your eardrum to release pressure and allow fluid to escape. An operation to remove your mastoid bone is known as a cortical mastoidectomy, and will only take place if your infection is severe. If you have a severely infected bone and it’s not removed, there is a risk of developing blood clots or brain abscesses, which can be life-threatening.

After surgery, you will be expected to stay in hospital for a few days, and will not be allowed to get your operated ear wet for at least a week after hospital release.

Swimming is allowed after four to six weeks, depending on how well your surgery has healed. Your local GP will be able to advise on recovery milestones at your check-up appointments.

If you suspect you have mastoiditis, contact your GP as soon as possible. Our experts will also be on hand should you need any additional support. For more information about other forms of ear infections, visit our overview, otitis externa, otitis media or labyrinthitis pages.

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