Mastoiditis: symptoms and treatment
Mastoiditis is an inflammatory lesion that covers the area of the temporal bone and is of an infectious origin. Most often, this disease occurs as a complication of otitis media. The most common symptoms are pain in the area of the mastoid process of the ear, the presence of edema and a decrease in the auditory function.
A mastoid process is a projection of the bones of the temple in the skull and is located behind the shell of the outer ear. Its structure is a set of cells that are separated by partitions. They can be filled with air, bone marrow or have the structure of a sclerotic type. The course of the disease depends on the type of affected cells. The disease is right-sided or left-sided.
Causes of disease occurrence
Mastoiditis usually occurs due to the spread of infections (pneumococcus, staphylococcus and others) from the middle ear. To get an infection in the mastoid process can, if the eardrum has too small a hole or for other reasons. Rarely, patients are diagnosed with a disease that occurs due to infection through the presence of sepsis or tuberculosis.
The main reasons for the appearance of an ailment are:
- gunshot wound
- mechanical damage;
- craniocerebral trauma
- other changes in the ear structure due to the transferred disease (external, middle or aero-otitis)
- chronic diseases (hepatitis, tuberculosis, diabetes mellitus)
- nasopharyngeal diseases (pharyngitis, sinusitis, laryngitis).
Types of ailment
Distinguish these forms of the disease, depending on the reasons for its occurrence:
- Primary (occurs after mechanical damage)
- secondary (formed against a background of other diseases).
According to the stages, these types of disease are distinguished:
- exudative (with fluid secretion)
- true (with the formation of bone processes)
According to the clinical form, the following are distinguished:
- typical manifestations : headache, pain in the ears
- atypical manifestations , in which the disease occurs almost imperceptibly or if atypical signs of the disease are present.
In addition, distinguish between chronic mastoiditis and acute mastoiditis. In the first case, all symptoms appear rather sluggish, and some are completely absent. In the second case, the patient complains of several signs of the disease, which manifest themselves quite clearly.
Separately, Bezold mastoidite is a variety that also causes swelling of the neck, purulent exudate is formed in the region of the tympanic membrane or sternocleidomastoid muscle.
Symptoms of the disease
Symptoms of mastoiditis are different, and it manifests itself, as a rule, together with an average purulent otitis media (at 2 or 3 weeks). Mastoiditis in children can develop even in the absence of a formed bone appendage (up to 3 years the process can not yet form).
Common symptoms of ailment are:
- reducing the perception of sounds
- elevated body temperature;
- acute pain behind the ear
- suppuration, which is observed from the external ear canal.
If the volume of suppuration considerably exceeds the size of the tympanic membrane or it is damaged, it indicates the spread of the disease further than the middle ear. If the amount of pus is insignificant — the infection does not spread further and the integrity of the tympanic membrane is preserved. The patient can observe protruding of the ear, the formation of smoothness behind the ear instead of the skin fold usually located there. Pus can spread to all parts of the skull, which causes the formation of blood clots, necrosis of the periosteum and the formation of an external fistula.
Complications of the disease can be:
- intracranial diseases (meningitis, encephalitis, thrombus formation)
- facial lesions (neuritis on the face)
- damage to neck functionality
- eye damage (panophthalmitic);
Diagnosis of the disease
Acute mastoiditis by a qualified otolaryngologist is able to diagnose within a few minutes. An exception may be an atypical form of the disease. Diagnosis is based on the patient’s testimony, receiving an anamnesis of life and illness, as well as palpation of the area behind the ear. Also an otolaryngologist will prescribe otoscopy, audiometry, bacussis and computed tomography of the ear, and in some cases a radiograph of the skull. This will help to detect the stage of the disease. Based on the research data, a diagnosis is made and a treatment plan is drawn up.
Treatment of the disease
Treatment of mastoiditis depends on the cause of the onset, the nature of the course, and the stage of the inflammation of the BTE. Distinguish such basic methods of treatment:
- the use of antibiotics, whose action is directed to the destruction of the foci of infection (Ceftriaxone, Cefixime, Cefotaxime);
- taking other medications (antihistamine, detoxification type)
- folk methods.
Administration of drugs is also called a conservative treatment, but its use is reasonable at the initial stages of mastoiditis, when the disease has not yet penetrated the ear tissues and the skull region. The patient is prescribed drugs of various types of action (for correcting the immunity, eliminating the consequences and causes of inflammation, and others).
The surgical method is a more effective method of combating the disease. The operation is performed on the middle ear, and in the absence of a drum in the region of the tympanic membrane providing drainage, a paracentesis is performed. In the course of the operation, which is under anesthesia, the doctor sprays the ear hole with various medications, cuts the periosteum, removes the upper plate of the bone behind the ear, and then sutures the wound. The patient should undergo hospitalization and daily dressing until the wound is finally prolonged.
Treatment of mastoiditis with the help of physiotherapy involves the imposition of warming compresses, UHF therapy, and ultraviolet irradiation of the patient. Folk methods, like physiotherapy, are usually auxiliary, but not basic.
There are many popular recipes for getting rid of the disease, among which:
- Treatment with a hot bulb. It is supposed to bake the bulb to a soft state, put a piece of butter and a bulb on the cheesecloth, wrap and insert it into the ear canal for 1-2 minutes. After wrapping the patient’s head with a warm blanket or a handkerchief
- Treating bread crust. It is supposed to be heated from two sides by a water bath, and then applied to the ear, warming it.
Prevention of disease
Prevent this disease if:
- timely detect signs of an inflammatory lesion
- qualitatively treat emerging otitis
- carry out manipulations of the sanitizing type (clear the ear of dirt, surplus sulfur, etc.)
- lead a healthy lifestyle
- eat right (observe the balance of proteins, fats, carbohydrates and vitamins)
- conduct immuno-regulatory therapy