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What is Chronic Mastoiditis?
Written by Medicover Team and Medically Reviewed by Dr SRS Pavan Kumar Kannuru , ENT
Chronic mastoiditis is a persistent infection or inflammation of the mastoid bone, located just behind your ear. It usually develops as a complication of untreated or recurrent middle ear infections (otitis media). The mastoid bone contains air cells that help drain fluid from the middle ear. When these air cells become infected or inflamed over time, chronic mastoiditis results.
Though less common now due to vaccines and antibiotics, chronic mastoiditis can still occur and may cause serious health problems if left untreated.
What Are the Common Causes of Chronic Mastoiditis?
The causes of chronic mastoiditis are often linked to recurrent or untreated acute otitis media. When the infection in the middle ear spreads to the mastoid bone, it can lead to mastoiditis. Factors contributing to this condition include:
- Recurrent ear infections: Persistent ear infections that are not adequately treated can spread to the mastoid bone.
- Obstruction of the Eustachian tube: This tube connects the middle ear to the back of the throat and helps equalize pressure. Blockage can lead to fluid build-up, creating an environment for infection.
- Compromised immune system: Individuals with weakened immune systems are more susceptible to infections, including those affecting the mastoid bone.
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Get Second OpinionWhat Are the Different Types of Mastoiditis?
- Acute Mastoiditis: Develops quickly, usually days after an ear infection. It resolves within weeks with treatment and rarely recurs.
- Chronic Mastoiditis: A long-standing infection lasting over a month, often linked to repeated or untreated ear infections.
What are the Chronic Mastoiditis Symptoms and Warning Signs?
Symptoms usually develop days or weeks after a middle ear infection and can vary in severity. Common signs of chronic mastoiditis include:
- Persistent ear discharge, often foul-smelling and containing pus
- Throbbing ear pain that doesn't go away
- Swelling, redness, or doughy soft tissue behind the affected ear, which may cause the ear to stick out
- Progressive hearing loss in the affected ear
- Low-grade or persistent fever
- Headaches that may worsen if the infection spreads
- Vertigo, confusion, or double vision in severe cases
In very young children (age 2 and under), additional signs include pulling at the affected ear, fussiness, and decreased activity.
Early diagnosis of these symptoms is important for prompt diagnosis and treatment to prevent complications.
How is Chronic Mastoiditis Diagnosed?
Early and accurate diagnosis of chronic mastoiditis is critical for effective treatment. Diagnosis typically involves a combination of clinical examination and diagnostic tests.
Clinical Examination
The first step is a thorough clinical examination by an otolaryngologist (ENT specialist). The doctor will examine the ear using an otoscope to look for signs of infection or inflammation. They will also assess the patient's medical history, including any recurrent ear infections.
Diagnostic Tests
There are several diagnostic tests that can help to confirm chronic mastoiditis:
- Imaging studies: CT scans or MRI scans of the mastoid bone can reveal the extent of the infection and any structural damage.
- Audiometry: Hearing tests are useful to access the severity of hearing loss and follow the effect of the infection.
- Culture and sensitivity tests: These tests involve taking a sample of the ear discharge to identify the causative organism and determine the most effective antibiotics.
What Are the Treatment Options for Chronic Mastoiditis?
The treatment of chronic mastoiditis focuses on getting rid of the infection, easing symptoms, and preventing complications. Since the condition can be stubborn, doctors usually use a combination of treatments. This might include antibiotics, regular check-ups, and sometimes surgery to help you recover fully and avoid the infection coming back.
Medical Treatment
- Antibiotics: Long-term antibiotic therapy is the cornerstone of treatment. To ensure effectiveness, the choice of antibiotics is usually guided by culture and sensitivity tests.
- Ear drops: If the infection inside the ear is the focus of treatment, an antibiotic might be given in the form of ear drops.
- Pain management: Analgesics and anti-inflammatory medications can help manage pain and reduce inflammation.
Surgical Treatment
In cases where medical treatment fails, or complications arise, surgical intervention may be necessary.
- Myringotomy: This procedure involves creating a small incision in the eardrum to drain fluid and relieve pressure.
- Mastoidectomy: In severe cases, surgical removal of the infected mastoid bone may be required. This procedure aims to eradicate the infection and prevent its spread to adjacent structures.
- Tympanoplasty: Reconstruction of the eardrum and middle ear structures may be necessary to restore hearing and prevent recurrent infections.
When to See a Healthcare Provider?
Chronic mastoiditis is a long-lasting infection of the mastoid bone, located just behind your ear. It usually happens after repeated ear infections and can cause serious problems if not treated.
See a doctor if you experience:
- Persistent or worsening ear pain
- Ear discharge lasting more than a few days
- Ear swelling or redness behind the ear
- Hearing loss or muffled hearing
- Fever associated with ear symptoms
- Facial weakness or paralysis
- Dizziness, confusion, or vision changes
If these symptoms last longer than 2 weeks or keep coming back, don't delay, get medical help.
People who need prompt care
- Anyone with a history of frequent ear infections
- Those with weakened immune systems
- Children, as they are more vulnerable to ear infections
Early treatment can prevent complications like bone damage or the spread of infection to nearby areas.
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How to Take Care of Yourself?
Managing chronic mastoiditis requires careful attention:
- Follow Medical Advice: Take all medications exactly as prescribed, even if symptoms improve early.
- Keep Ears Dry: Avoid swimming and water exposure during treatment. Use a cotton ball coated with petroleum jelly during showers to prevent water entry.
- Rest and Elevate Head: Rest helps recovery, keeping your head elevated reduces swelling.
- Avoid Smoking and Secondhand Smoke: Smoke irritates your ears and respiratory system, increasing infection risk.
- Watch for Symptoms: Report new or worsening symptoms immediately to your doctor.
- Regular Follow-Up: Attend all ENT appointments to monitor healing and hearing.
Preventing Chronic Mastoiditis
Prevention of chronic mastoiditis is essentially through successful control and treatment of acute otitis media. Key preventive measures include:
- Timely treatment of ear infections: Ensuring that ear infections are adequately treated with the appropriate antibiotics can prevent the progression of chronic mastoiditis.
- Regular medical check-ups: Regular visits to an ENT specialist can help in the early detection and management of recurrent ear infections.
- Maintaining ear hygiene: Avoiding the accumulation of moisture or dirt in the ear canal, such as by drying the ears after swimming.
What are the Complications of Chronic Mastoiditis?
Untreated chronic mastoiditis may lead to serious complications. These include:
- Meningitis: The infection can spread to the meninges, the protective membranes covering the brain and spinal cord, leading to meningitis.
- Brain abscess: An abscess may form in the brain if the infection spreads, posing a life-threatening condition.
- Facial nerve palsy: The facial nerve, which runs through the middle ear, can be affected, leading to facial paralysis.
- Hearing loss: Chronic infection can cause permanent damage to the structures of the ear, resulting in irreversible hearing loss.
Our Experience Treating Chronic Mastoiditis
At Medicover, we understand how painful and frustrating chronic mastoiditis can be. Our team of ENT specialists is dedicated to providing gentle, effective treatment to help you get rid of your symptoms and get over the infection.
We offer:
- Detailed ear examinations and advanced imaging tests
- Personalized treatment plans including antibiotics and ear cleaning
- Surgical options if needed, to remove infected tissue safely
- Ongoing support to protect your hearing and prevent future infections
With Medicover, you get expert care combined with kindness and respect. We are committed to helping you heal and enjoy better ear health.
