Mastoiditis is a rare condition affecting the bone behind the ear. It can be serious and cause significant problems for the sufferer. The ailment occurs more often in children although it does also affect adults. The mastoid has a honeycomb-like structure with cells full of air which communicate with the air space of the middle ear. Chronic inflammation of the middle ear can cause mastoiditis. This can lead to the bone in the mastoid breaking down.
Symptoms may be mild and the diagnosis often goes undetected for some time. They include redness, tenderness and soreness behind the ear. There may also be swelling behind the ear leading to it protruding. The ear may discharge and the patient may have a fever and be tired and irritable. Deafness, headaches and itching may also occur.
If you or your child has any of these symptoms you must visit your GP. You should also seek medical advice if one of you has an ear infection which doesn't settle down or have new symptoms after an ear infection.
Mastoiditis often occurs after an inadequately controlled middle ear infection. It can also occur secondary to a cholesteatoma. Your GP will examine your ear with an otoscope and look for signs of middle ear infection or a cholesteatoma. If they think you may have a chronic middle ear infection or mastoiditis they will consider sending you to an Ear, Nose and Throat surgeon. Sometimes a detailed CT scan is required to make the diagnosis.
If the condition is diagnosed then you may need an operation to remove the infected cells. An anaesthetist will put you to sleep then the surgeon will clean the area behind your ear to sterilize it. They will then make a cut in the skin overlying the mastoid bone. They will cut into the bone and remove the damaged air cells. The skin will be closed up and the anaesthetist will allow you to wake up.
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WHAT ARE THE CAUSES OF EARACHE?
Earache is a common symptom. There are many possible causes of earache, the commonest is an ear infection. Other signs of this include itchiness, irritation, reduced hearing and discharge.
Other causes of earache include change in pressure. This can occur in an aeroplane or when climbing a mountain. It is also common to have discomfort while scuba-diving. The change in pressure can cause a pressure gradient to form across the ear drum. This causes stretching and pain. When you go up in an aeroplane the atmospheric pressure drops. Even in a pressurised cabin such as that of a passenger jet there is still a drop in the pressure. Normally the Eustachian tube compensates for this. However, if you have a cold or other inflammation around the back of the nose then the pressure in the middle ear builds up.
Other causes include a foreign object in the ear. If a centipede or other insect crawls into your ear during your sleep you may not be aware of it. The first you find out might be that you have ear pain in the morning. Using cotton earbuds is also a common cause of ear discomfort. They can cause trauma to the delicate skin lining the ear canal. They should not be inserted down the canal and should only be used around the outside.
Irritants such as soaps and shampoos can also cause soreness. This can be avoided by rinsing the ears and not leaving shampoo on for too long. Alternatively you could use earplugs to keep the soap out.
Dr Toby Bateson for ZenPlugs Ltd