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

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, a person risks facing face-to-face with meningitis - inflammation of the meninges, brain abscess, purulent inflammation of the ear, often leading to complete deafness.

Causes of

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

Already at this stage the patient can feel numerous painful symptoms. Initially, the disease ca

n be caused by pathogens of pneumococcus, streptococcus, as well as gram-negative microflora.

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

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

Pathology can not be ignored even at its first manifestations, otherwise, if the complication occurs, the patient will be forced to carry out more serious treatment, up to surgical intervention.

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

The photo shows the site of localization of mastoidite

what is mastoiditis


Mastoiditis is characterized by a whole complex of symptoms, which are easy to recognize if you are attentive to your 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.

General and local symptoms of mastoiditis are distinguished in medicine:

General symptoms of Local symptoms of
Poor health, fever, puffiness in the back of the ear, painful sensation when pressing on the inflamed area, possibly having a purulent discharge from the ear Noise in the head,severe pain with palpation of the affected area, redness of the skin around the diseased area, bulging of the auricle, smoothedness of the bovine folds, swelling of the

When the patient's sagging worsensIthomi may disrupt the hearing. This will indicate the presence of copious purulence. Later, a person begins to suffer from frequent dizziness.

The involvement of the facial nerve is not excluded, which further causes some difficulties 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 purulent inflammatory process is designated as a complication of otitis media, which is able to penetrate exclusively into the arthrum-drum cave located in the 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.

In older children, there is a similar symptomatology. 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.

Species of the disease

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 be absent altogether. The same applies to the accumulation of pus. Atypical form almost always causes the destruction of bone tissue and can lead to complications of intracranial nature.


This type of mastoidite has a sluggish current. 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 a sharp onset of deterioration. Among them the paresis of the facial nerve is the main one.

Photo of how the mastoidite looks

types of mastoiditis


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. Mucosa thickens considerably due to infection.
  2. Exudate( a turbid liquid that appears in places of inflammation of tissues) penetrates into cells, destroys them and at the same time forms a cavity filled with pus.
  3. The accumulated pus accumulates into the malar spine.

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

  • Increase in body temperature to 39-40 ° C.
  • Divergent pain in forehead and occiput. Increased 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 broader than in the acute form. Patients are concerned about 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

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 fighting the inflammatory process.

Despite the abundance of medicines, 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 mastoiditis will be favorable only in one case: if the patient has responsibly approached the treatment and passed the necessary diagnostics.

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

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

Preventive measures

The most reliable preventive measure of mastoiditis is the timely treatment of any form of otitis media. 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.

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