Mastoiditis of the ear: symptoms, treatment, purulent, atypical, chronic forms

August 12, 2017 15:30 | Otitis

Without exaggeration, mastoiditis is a serious acute inflammatory process that develops against the background of a neglected stage of otitis.Purulent inflammation progresses on the mucosa of the bone tissue, which is immediately behind the ear.

The disease develops quickly enough if you do not take proper measures to eliminate it.In the future, the infection begins to go beyond the epicenter of inflammation and passes to the skull and brain.

In this case, instead of otitis person at risk to face with meningitis - an inflammation of the meninges, brain abscess, purulent inflammation of the ear, often resulting in complete deafness.

Reasons for

Mastoiditis provokes a lack of proper treatment for otitis media.So, the inflammatory process continues to progress, begins to affect other, healthy tissues, which in the near future is reflected in the mastoid process behind the ear.

Already at this stage the patient can feel numerous painful symptoms.Initially, the disease can be caused by pathogens of pn

eumococcus, streptococci, as well as gram-negative microflora.

The most vulnerable to this disease are people belonging to the following risk group:

  • diabetes mellitus;
  • chronic kidney disease;
  • presence of obstructed outflow of fluid from the drum cavity;
  • chronic ear ailments.

Pathology can not be ignored, even when it first forms, or upon the occurrence of complications, the patient will be forced to implement more serious treatment, amounting up to surgery.

To prevent the development of an ailment, one should be familiar with the first symptoms from which its manifestation begins.

The photo shows a part of localization mastoiditis

What is mastoiditis


Mastoiditis is characterized by a complex of symptoms, recognize that simply, to be attentive to their condition.

Mastoiditis in adults

In adults, the disease can be sluggish and acute.Mastoiditis can manifest itself in the form of puffiness and for a long time do not make itself felt.But this does not mean that there is no puffiness completely.

It is possible that due to the daily bustle, a person could simply not notice it.

In medicine allocate general and local symptoms of mastoiditis:

Common symptoms Local symptoms
feeling unwell, fever, appearance of swelling behind the ear, the occurrence of pain on pressure on the inflamed area, the possible presence of ear gnoevydeleniya noise in my head, hearing loss, severe pain on palpation of the diseased area, redness around the patient area, ottopyrivanie pinna, smoothednnosti BTE folds, swelling

is possible defeat of the facial nerve, which further causes some difficulty in getting rid of this problem.

In children

In children, the disease occurs in virtually the same scenario as in adults.But still in the case of mastoiditis in children there are some differences.So, small infants do not have a formed process behind the ear.

This leads to the fact that the entire suppurative inflammatory process is referred to as a complication of otitis media, which can penetrate only in artrum cave-drum, which is in back of the ear.

The disease is often lethargic.There may be an insignificant increase in temperature, irritability, loss of appetite.Later, parents find a small redness behind the ear, which soon turns into swelling.

Older children have similar symptoms.The treatment is carried out in a hospital setting and is assigned exclusively individually.The attending doctor relies on the age, weight and general condition of the child at the time of the clinic visit.

Variety of diseases

Depending on the variety, mastoiditis manifests itself as a different symptom and gives a certain number of complications.There are three main types of mastoidite.


With purulent mastoiditis, the patient may feel a ripple in the process area.This indicates the accumulation of pus in this area.

If the purulent contents break through( most often this happens in the absence of timely diagnosis), then the pus flows and focuses under the soft tissues, a subperiosteal abscess appears.

The skin swells up, and the auricle can bend under the influence of purulent masses.


This type of disease is the most dangerous for human health.

Atypical mastoiditis has no specific stages in the development of the disease, and its symptoms are often very mild, which is a great danger.

Pain syndrome may not be present at all.The same applies to the accumulation of pus.Atypical form almost always causes destruction of bone tissue and can lead to complications of intracranial nature.


This type of mastoidite has a lingering flow.Latent mastoiditis does not have a pronounced pain syndrome with pressure in the place of the mastoid process, a person does not experience the fever typical for the disease.

The main danger is the sharp onset of deterioration.Among them the paresis of the facial nerve is the main one.

The chronic and acute forms of mastoiditis differ from each other in the nature of the course of the disease, signs and symptoms.


Acute phase occurs when complications of middle ear inflammation occur.A characteristic feature of acute mastoiditis is its gradual course.There are three stages in total:

  1. The mucosa thickens considerably due to infection.
  2. Exudate( a turbid liquid that appears in the areas of tissue inflammation) penetrates into the cells, destroys them and at the same time forms a cavity filled with pus.
  3. The accumulated accumulation of pus penetrates the zygomatic process.

But the following signs indicate the transition of the disease to a more complicated stage:

  • Increase in body temperature to 39-40 ° C.
  • Divergent pain in forehead and occiput.Increasing pain syndrome when taking upright position.
  • Nausea and vomiting.
  • Confusion of consciousness, as a sign of infection of blood.


The course of chronic mastoiditis can last about 3 months in a row.There are two main forms - primary and secondary.

Primary form occurs as a result of injuries, injuries, fractures of the skull bones or infections.The secondary form arises as a complication of otitis.

The clinical picture of the course of chronic mastoiditis is wider than in the acute form.Patients are concerned with the following symptoms:

  • Pain in the ear and around it, passing into the teeth, eye socket, occiput and parietal area.
  • A feeling of pulsation in the process area.
  • Swelling and redness of the skin behind the auricle.
  • Purulent discharge.
  • Outstretched auricle.General malaise, drowsiness and lethargy.


Diagnosis of mastoiditis Diagnosing an explicit mastoiditis is not difficult.More severe is the diagnosis of an atypical type of disease, when there are no obvious symptoms( edema, suppuration, soreness).

An important method of studying the disease is radiography.But the most effective are CT and MRI of the bone tissues of the temporal region.

The doctor examines the tympanic membrane and the area behind the ear.Blood tests can also be prescribed.In this case, the parameter of interest to the doctor is ESR.This characteristic can talk about the inflammatory process in the body and its intensity.


Treatment of mastoiditis is carried out in a hospital.The main methods of fighting the disease are surgical and conservative.

The conservative method is aimed at providing the patient with an uncontaminated outflow of pus from the ear region and combating the inflammatory process.

Despite the abundance of medications, surgical intervention is still the most effective in the fight mastoiditis.

Antrumastoidotomy is an operation in which under general anesthesia a patient is made a small incision behind the auricle and opens the mastoid process.


The prognosis for the occurrence of mastoiditis will be favorable only in one case: if the patient has responsibly approached the treatment and undergone the necessary diagnostics.

With the use of conservative and surgical methods of fighting the disease, in the vast majority of cases of life and health of the patient does not threaten anything, and therapy gives a positive prognosis.

What to do if it hurts behind the ear, see in our video:

Preventative measures

The most reliable preventive measure of mastoiditis is the timely treatment of any form of otitis.If you do not allow the onset of the disease and its further progression, then it is unlikely that a person will encounter mastoiditis.In addition to otitis media, it is important to be responsive to any of the diseases related to otolaryngology.