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Mastoiditis: Symptoms and Treatments

Mastoiditis is a severe infection of the prominent bone behind your ear that can cause serious, even life-threatening, health complications – and as such, timely medical treatment is required.

It is usually more common in children, although adults can also sometimes be affected. Regardless of age, any suspected signs of mastoiditis should be reported to your GP immediately. We'll look at the causes, as well as how it is diagnosed and medically treated.

What is mastoiditis of the ear?

Just behind and under the ear is the hard, prominent bone known as the mastoid process. It has a honeycomb-like structure that contains air spaces; these are called mastoid cells. If the mastoid cells become infected or inflamed – often because of a persistent middle ear infection (otitis media) – this can cause the bone to break down, resulting in pain and possibly far more serious health issues.

What are the causes?

The main cause is when an middle ear infection that simply won’t go away, eventually spreading to the back of the ear and through the temporal bone. If the honeycomb structure of your mastoid bone becomes infected and inflamed, mastoiditis will inevitably ensue.

It’s also worth bearing in mind that, despite being far less common, mastoiditis can also be brought on by cholesteatoma – when a growth of skin cells behind the eardrum prevents the ear from draining properly.

What are the symptoms?

Symptoms can range from asymptomatic disease to progressive mastoiditis with potentially life-threatening complications, so it’s important to seek medical attention right away.
The most common visible symptoms of mastoiditis include:

  • Pain, sensitivity, or swelling around/behind the ear
  • Redness behind the ear
  • Ear discharge
  • Swelling behind the eyes
  • Headaches
  • Hearing loss in the affected ear
  • Tiredness and irritability
  • Fever

If any of the above signs apply to you, don’t panic – at least you know you need to visit a qualified medical professional to confirm diagnosis.

What treatments are available?

Treatment usually consists of a course of antibiotics. Whether you take tablets for a few days or are treated intravenously in hospital under the supervision of specialists, this is the most common way to manage your condition.

Alternatively, surgery may be necessary. The type of procedure can vary and includes a myringotomy, which drains fluid from the middle ear, or – in severe cases – a mastoidectomy, removing part of the infected mastoid bone.

Unfortunately, mastoiditis can develop to the point where it causes significant implications for the patient – therefore, the importance of early diagnosis and treatment cannot be overstated. These include:

  • Permanent hearing loss
  • Blood clots
  • A brain abscess

Antibiotics should treat your mastoiditis quickly; in some cases, relief from symptoms can be seen within a few days. Still, it’s important to finish the whole course, even if you’re feeling better.

If you’ve had surgery for mastoiditis, you’ll probably need to take one or two weeks off work – the average recovery time. During recovery, you should avoid getting your ears wet and take painkillers as required.

Prevention of mastoiditis

Most of the time, preventing mastoiditis boils down to effectively treating middle ear infections. Make sure to visit your GP early and receive appropriate treatment: If your ear infection is cleared up sooner rather than later, there will be less chance of it spreading and developing into mastoiditis.

Frequently asked questions

Can mastoiditis cause headaches?

Yes, it can. One of the main warning signs of mastoiditis is headaches, so be sure to see the doctor if these are accompanied by any ear-related symptoms as well.

How is diagnosis of mastoiditis confirmed?

After first examining the inside of your ear, a doctor will usually be able to determine whether you have mastoiditis or another condition. If they suspect mastoiditis, you will most likely be referred to an ear, nose, and throat specialist (ENT) for further investigation. Confirming a diagnosis may involve one or more medical procedures, such as a blood test and/or checking any discharge for infection. A more detailed view of the skull - which is typically required in patients who are children – might also warrant a CT or MRI scan.

Is mastoiditis serious?

By getting treated promptly, your mastoiditis can be easily resolved. However, delaying treatment often increases the risk of the infection becoming much more severe, with potentially life-altering consequences.

Given the potential impact of mastoiditis on your hearing – and indeed general health – it’s vital you have any suspected symptoms checked by a doctor or qualified audiologist immediately.