Difference between revisions of "Mastoiditis"

(Clinical Features)
Line 20: Line 20:
*Abnormal pinna findings
*Abnormal pinna findings
**Protrusion of auricle, obliteration of postauricular crease
**Protrusion of auricle, obliteration of postauricular crease
*Cranial nerve VI and VII palsies
*[[Cranial nerve abnormalities|Cranial nerve VI and VII palsies]]
==Differential Diagnosis==
==Differential Diagnosis==

Latest revision as of 17:31, 16 August 2019


Cross sectional ear anatomy (left).
  • Inflammation of middle ear spreads into mastoid air cells via the "aditus ad antrum"
  • Vast majority of acute mastoiditis occurs as a result of, or simultaneous with, acute otitis media
    • Mastoiditis is unlikely if middle ear examination is normal


Mastoiditis with subperiostal abscess

Clinical Features

  • Abnormal TM findings
  • Abnormal mastoid findings
    • Erythema, edema, tenderness
  • Abnormal pinna findings
    • Protrusion of auricle, obliteration of postauricular crease
  • Cranial nerve VI and VII palsies

Differential Diagnosis

Ear Diagnoses





CT scan: Otitis media (single arrow) and mastoiditis (double arrow) of the right side (left side in image). The external auditory canal is partially occupied by suppuration (triple arrow).
  • Middle ear fluid cultures
  • CT mastoid with IV contrast
    • 90% sensitive
    • Delineates extent of bony involvement
    • Helps to diagnosis abscess formation


  • ENT consultation - cases refractory to parenteral antibiotics may require surgical irrigation and debridement with possible mastoidectomy.

Coverage against S. pneumoniae, S. pyogenes, S. aureus, H. influenzae


  • Admit


Include, but are not limited to:

See Also