Mastoiditis 👂

 Definition

Infection of mastoid antrum or mastoid air cells is called as mastoiditis.

B) Acute Mastoiditis

Aetiology - it is mainly caused by acute otitis media

In otitis media following factors are responsible

A) Inadequate drainage : 

if the exudates is not draining well infection may spread to the mastoid

B) Virulence of organisms : The infection may spread if the organisms are virulent.

C) Lowered resistance : Because of the disease like dehydration and diabetes

D) Inadequate or improper Antibiotics :

E) Cellular mastoiditis : are more likely to be involved

a) latarrhal mastoiditis

b) Coalescent mastoiditis

a) latarrhal mastoiditis

It is caused by acute supportive otitis media, there is congestion of the mucosa of the mastoid.

Clinical features :

1) pain : 

recurrence of pain which was present with acute otitis media it became more severe and boring in character in the mastoid region

2) Constitutional symptoms :

Body ache, headache, malaise, fever, weakness.

3) Otorrhea :

Creamy yellow in color.

4) Deafness :

May Increased further.

5) Tenderness : On mastoid antrum.

B) Coalescent mastoiditis :

1) Due to the spread of infection, granulation, and oedema develop and they block partially or totally the aditus to antrum.

2) pus collects in the mastoid cavity under pressure with the breakdown of septa between the air cells.

3) The air cells in the mastoid coalesce and the mastoid cavity become converted into a bag of pus (empyema). 

Clinical features :

1) pain becomes more severe.

2) constitutional symptoms more marked.

3) Slowly  increasing tachycardia.

4) Ottorhea

5) Ear drum - congested.

6) Tenderness on mastoid antrum.

7) External auditory canal - shows oedema and sagging of Posterosuperior portion.

2) Chronic mastoiditis :

Occurs due to chronic suppurarative otitis media.

Benign chronic otitis media may produce scanty granulation in the mastoid.

Dangerous chronic otitis media with cholesteatoma may erode the mastoid bone gradually the mastoid becomes filled with cholesteatoma and granulation.

Investigation :

Radiography :

Catarrhal mastoiditis shows clouding of air cells in the mastoid bone

Coalescent mastoiditis shows break down of mastoid air cells and the cells undergo coalescence.

Chronic mastoiditis shows a sclerotic mastoid with or without Erosion of bone in the sclerotic area.

Treatment

A) Mastoiditis :

A) For catarrhal mastoiditis

Conservative treatment for acute otitis media Antibiotics

Myringotomy

A) For Coalescent mastoiditis

Simple mastoridectomy to drain the mastoid cavity.

Antibiotics : tab. Cefuroxine (ceftum) 250 mg bd × 7 days.

Other - Tab. Voveron 100 mg bd

              Tab. chymoral forte wid.

              Refer to ENT specialist

Chronic mastoiditis :

Radical mastoidectomy is necessary if cholesteatoma is present.

Homeopathic Remedies for mastoiditis :

1) Aurum met.

2) belladonna

3) Silica

4) Capsicum

5) Onosmodium

6) Nit acid

7) Fluoric acid