Patient education: Mastoiditis (The Basics)

What is mastoiditis? — 

This is an infection in the "mastoid," which is a bone behind the ear (figure 1). The mastoid contains spaces that are filled with air. When there is an infection, these spaces can fill with pus.

Mastoiditis usually happens after an ear infection. It is more common in children than in adults. It can spread and cause serious problems if it is not treated.

What are the symptoms of mastoiditis? — 

Symptoms can include:

●Swelling or redness of the skin behind the ear

●The ear sticking out due to swelling behind it

●Ear pain

●Fever

Sometimes, the infection can spread to other nearby areas. This can be serious. For example, it can affect the:

●Nerves of the face

●Inner ear

●Bones of the skull

●Brain

Depending on where the infection has spread, it can cause different symptoms.

Is there a test for mastoiditis? — 

Yes. Doctors can usually diagnose mastoiditis by doing an exam, looking in the ear, and learning about a person's symptoms. But sometimes, they will order an imaging test like CT or MRI scans to confirm. These create pictures of the inside of the ear and head.

Your doctor might also do other tests, such as:

●Blood tests

●Tests on a sample of fluid from the ear

The results can help the doctor decide how to treat the infection.

How is mastoiditis treated? — 

Treatment can include:

●Antibiotics – Most people get antibiotics in the hospital through an IV. (This is a thin tube that goes into a vein.) The doctor might also prescribe antibiotics to keep taking after going home. If so, it's important to finish all the medicine.

●A procedure to drain fluid – Mastoiditis can cause pus to build up inside the ear. A doctor can drain the pus using a needle or by making a small cut in the eardrum. They might also place a tube in the eardrum to help drain fluid (figure 2).

●Surgery – If antibiotics do not work, or if the infection has spread or caused other problems, doctors can do surgery to remove the infected part of the mastoid. This is called "mastoidectomy."

In the hospital, the staff will monitor you or your child to make sure your symptoms improve. This usually happens within a day or 2 of starting treatment.

Can mastoiditis be prevented? — 

Sometimes. The best way to lower the risk of mastoiditis is to get treatment if you have an ear infection. For children, doctors sometimes don't prescribe antibiotics right away, and the infection goes away on its own. But treatment is usually needed if symptoms get worse or continue for more than a few days.

Since mastoiditis is most often caused by an ear infection, it might help to try to lower your or your child's risk of ear infections. For example:

●Avoid smoking or being around smoke

●Wash your and your child's hands often

●Stay away from people who are sick

●Get all the recommended vaccines for both you and your child

When should I call the doctor? — 

Call your doctor or nurse right away if you:

●Have numbness in your face, or cannot move part of your face

●Have dizziness, nausea, or trouble with balance

●Have hearing problems

●Have pain or other symptoms that are not improving with antibiotic treatment

If your child was sent home from the hospital after being treated for mastoiditis, call their doctor or nurse if they:

●Seem very sleepy or confused, or are not responding normally

●Have numbness in their face, or cannot move part of their face

●Have a severe headache or stiff neck

●Have dizziness or trouble with balance

●Have nausea or vomiting, and cannot keep fluids down

●Have a fever, pain, or other symptoms that are not improving with antibiotic treatment

More on this topic

Patient education: Ear infections in adults (The Basics)
Patient education: Ear infections in children (The Basics)
Patient education: Ear tubes (The Basics)

Patient education: Ear infections (otitis media) in children (Beyond the Basics)