Difference between revisions of "Mastoiditis"

Line 12: Line 12:
 
**Protrusion of auricle, obliteration of postauricular crease
 
**Protrusion of auricle, obliteration of postauricular crease
 
*Cranial nerve VI and VII palsies
 
*Cranial nerve VI and VII palsies
 +
 +
==Differential Diagnosis==
 +
{{Ear DDX}}
  
 
==Diagnosis==
 
==Diagnosis==
Line 19: Line 22:
 
**Helps to diagnosis abscess formation
 
**Helps to diagnosis abscess formation
  
==Differential Diagnosis==
+
==Management==
{{Ear DDX}}
 
 
 
==Treatment==
 
 
===[[Antibiotics]]===
 
===[[Antibiotics]]===
 
{{Mastoiditis Antibiotics}}
 
{{Mastoiditis Antibiotics}}
 
  
 
==Disposition==
 
==Disposition==
Line 34: Line 33:
 
*[[Eponyms_(A-B)#Bezold.27s_abscess|Bezold abscess]]
 
*[[Eponyms_(A-B)#Bezold.27s_abscess|Bezold abscess]]
  
==Source==
+
==References==
Tintinalli
 
  
 
[[Category:ENT]]
 
[[Category:ENT]]
 
[[Category:ID]]
 
[[Category:ID]]

Revision as of 16:43, 26 May 2015

Background

  • Inflammation of middle ear spreads into mastoid air cells via the "aditus ad antrum"
    • Can extend into cranial cavity and lead to brain abscess
  • 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

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

External

Internal

Inner/vestibular

Diagnosis

  • Middle ear fluid cultures
  • CT mastoid with IV contrast
    • Delineates extent of bony involvement
    • Helps to diagnosis abscess formation

Management

Antibiotics

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

Disposition

  • Admit

See Also

References