What is Chronic Suppurative Mastoiditis? Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Neha A Padia , ENT

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Chronic suppurative mastoiditis is a persistent infection and inflammation of the mastoid bone located behind the ear. It usually develops as a complication of long-standing or untreated middle ear infections. The condition can cause pus formation, damage to the mastoid air cells, hearing loss, balance problems, and, if left untreated, the spread of infection to nearby structures. Early diagnosis and appropriate treatment are essential to prevent serious complications and preserve hearing.

What are the Types of Chronic Suppurative Mastoiditis?

Chronic suppurative mastoiditis can occur in different forms depending on the underlying cause and extent of the infection.

Tuberculous Chronic Suppurative Mastoiditis: A rare form caused by Mycobacterium tuberculosis, characterized by chronic ear discharge and destruction of the mastoid bone.
Cholesteatomatous Chronic Suppurative Mastoiditis: Associated with a cholesteatoma, an abnormal skin growth behind the eardrum that causes chronic infection and damage to the middle ear.
Petrositis: A severe infection involving the petrous portion of the temporal bone that may cause hearing loss, facial paralysis, and persistent ear pain.
Bezold Abscess: A complication in which pus spreads from the mastoid bone into the neck, causing swelling, pain, and possible airway compromise.
Lateral Sinus Thrombosis: A rare but life-threatening complication where a blood clot forms in the lateral venous sinus, leading to fever, headache, and neurological symptoms.

What are the Symptoms of Chronic Suppurative Mastoiditis?

Symptoms may develop gradually and often indicate a persistent infection affecting the mastoid bone and surrounding ear structures.

Persistent ear pain.
Continuous or recurrent ear discharge.
Hearing loss.
Swelling or tenderness behind the ear.
Fever.
Fatigue.
Dizziness or vertigo.

What are the Causes of Chronic Suppurative Mastoiditis?

Chronic suppurative mastoiditis is usually caused by a persistent bacterial infection that spreads from the middle ear into the mastoid bone. Untreated or recurrent ear infections are the most common underlying cause.

Common causes include:

Untreated acute otitis media.
Recurrent middle ear infections.
Inadequate treatment of ear infections.
Poor drainage of infected middle ear fluid.
Weakened immune system.
Ear trauma or injury.
Structural abnormalities of the ear.
Persistent bacterial infection in the middle ear.

When to See a Doctor for Chronic Suppurative Mastoiditis?

If you have persistent ear discharge, ear pain, hearing loss, swelling behind the ear, or symptoms of a chronic ear infection, consult an ENT Specialist. Early diagnosis and treatment can help prevent complications, preserve hearing, and stop the infection from spreading.

If you have persistent or recurrent ear discharge lasting for several weeks.
If you experience ongoing ear pain, tenderness, or swelling behind the ear.
If you notice hearing loss, ringing in the ears (tinnitus), or a feeling of fullness in the affected ear.
If you develop redness, warmth, or swelling around the mastoid bone behind the ear.
If you have fever, severe headache, dizziness, or balance problems along with ear symptoms.
If your symptoms do not improve with antibiotics or keep recurring despite treatment.
If you experience facial weakness, severe ear pain, confusion, or signs of a spreading infection, seek immediate emergency medical attention.
If your symptoms persist or worsen, consult an ENT Specialist for a comprehensive evaluation, hearing assessment, appropriate imaging if required, diagnosis, and a personalized treatment plan.

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How is Chronic Suppurative Mastoiditis Diagnosed?

Diagnosis involves evaluating your symptoms, examining the ear, and performing imaging or laboratory tests to determine the extent of the infection.

Otoscopy.
Audiological testing (Audiometry).
Imaging studies such as CT scan or MRI.
Microbiological culture and sensitivity testing of ear discharge.
Mastoidectomy tissue sample analysis when indicated.
Blood tests to assess inflammatory markers.

How is Chronic Suppurative Mastoiditis Treated?

Treatment focuses on eliminating infection, preserving hearing, relieving symptoms, and preventing complications.

Antibiotics: Used to eliminate bacterial infection and control inflammation.
Mastoidectomy: Surgical removal of infected mastoid air cells to eradicate infection and improve drainage.
Tympanoplasty: Surgical repair of the eardrum and middle ear structures damaged by chronic infection.
Ear Drops: Antibiotic or corticosteroid ear drops help reduce infection and inflammation.
Hearing Aids: May be recommended for patients with permanent hearing loss caused by chronic mastoid disease.

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What are the Risk Factors for Chronic Suppurative Mastoiditis?

Several factors increase the likelihood of developing chronic suppurative mastoiditis, particularly those associated with recurrent ear infections or reduced immunity.

Young age.
Previous ear infections.
Weakened immune system.
Cleft palate.
Down syndrome.
Smoking.
Allergies.
Exposure to secondhand smoke.
Poor nutrition.
Living in crowded or unhygienic conditions.

Frequently Asked Questions

1. What is chronic suppurative mastoiditis?

Chronic suppurative mastoiditis is a longstanding infection of the mastoid bone in the skull, typically resulting from untreated acute mastoiditis.

2. What are the symptoms of chronic suppurative mastoiditis?

Symptoms may include persistent ear pain, drainage from the ear, hearing loss, fever, and swelling behind the ear.

3. How is chronic suppurative mastoiditis diagnosed?

Diagnosis is typically made through a physical exam, medical history review, imaging tests like CT scans, and possibly a culture of ear drainage.

4. What are the treatment options for chronic suppurative mastoiditis?

Treatment may involve antibiotics, ear cleaning procedures, surgery to remove infected tissue or repair damage, and hearing aids.

5. Can chronic suppurative mastoiditis lead to complications?

Yes, if left untreated, chronic suppurative mastoiditis can lead to serious complications such as hearing loss, meningitis, facial nerve paralysis, and brain abscess.