Masked mastoiditis is a potentially serious infection of the mastoid which often goes unnoticed. The mastoid is the bony lump behind your ear. It is full of air cells and is lined with mucosa. This is a type of skin which generates its own watery mucus. The condition leads to the gradual breakdown of the air cells. There is no pain, swelling or discharge. The diagnosis is easily missed.
Masked mastoiditis often follows an episode of middle ear infection. It may appear to have been well treated with a course of antibiotics. The clinical signs of the condition are not obvious. Low-grade bone infection occurs. Pus does not form. Complications are common partly because of the difficulty in diagnosis.
CT scans and x-rays do not show specific changes but a bone scan may show invasion of the bone. Antibiotics may lead to a queue but usually surgery is essential.
Often it occurs due to the choice of antibiotics not being adequate to treat an ear infection. This may be because they are the wrong type, or they are given with the wrong frequency, dose or treatment duration.
Children are commonly affected. Often they present with a general feeling of illness with some discomfort behind the ear and hearing loss. The tympanic membrane may appear thickened and white. It may hurt on pressing over the mastoid bone. Hearing tests may show a degree of conductive deafness. This is the type of deafness which can be caused by blockage of the ear.
Many of the patients will need to be seen by the ear nose and throat consultant. This is partly because of difficulty in diagnosing the condition. In addition it may be slow to resolve and cause hearing problems.
Indications that an ear problem is caused by masked mastoiditis are recent middle ear infection and deafness. Other signs are an abnormal eardrum and discharge. Patients may need admission to hospital. Adequate treatment is very important in order to get the problem controlled.
An operation may be performed. The aim is to remove all the infected cells in the mastoid. The outer part of the bone is removed using a drill and the cells are removed.
If you think you have an ear condition you must see your GP. This article should never be treated as medical advice.
Dr Toby Bateson for ZenPlugs.com