Mastoiditis

Revision as of 22:23, 1 March 2015 by Rossdonaldson1 (talk | contribs) (Diagnosis)

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

Diagnosis

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

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Treatment

  • IV Abx
    • Vancomycin + (ceftazidime OR cefepime OR piperacillin-tazobactam)

Disposition

  • Admit

See Also

Source

Tintinalli