Have you ever noticed that your little one has an earache and then suddenly, just as it was getting better, the back of the ear became swollen, red, and painful to the touch? Or have you ever experienced this yourself? Don't dismiss this as a simple earache. This could be a serious condition that can be caused by an untreated middle ear infection. Today, we're talking about a condition called 'Mastoiditis', which you should suspect at a time like this.
What is this Mastoiditis?
Simply put, mastoiditis is a bacterial infection of the mastoid bone, which is part of the skull behind our ears. This bone is not just a solid bone. Inside it, like the tiny holes in a honeycomb, there are many small air-filled chambers (air cells). The main function of these is to protect the delicate structures inside the ear, regulate the pressure in the ear, and minimize damage to the skull in the event of an accident.
What usually happens is that if a middle ear infection (otitis media) is not treated properly, the bacteria that caused the infection spread from the middle ear to the air spaces in the mastoid bone. This is when mastoiditis occurs. This condition is most common in young children, but it can also occur in adults.
Because the most important nerves and blood vessels in our body pass through this mastoid bone, if an infection occurs here, it can spread outside the bone and cause very serious health complications.
Some people may also have a long-term condition called 'Chronic Mastoiditis', which causes a persistent pus-like discharge from the ear.
Why does this situation occur?
As I mentioned before, the main and most common cause of this is an untreated or incompletely treated middle ear infection (Otitis Media). Bacteria in the middle ear gradually migrate to the mastoid bone.
In addition, a very rare cause is a condition called 'cholesteatoma'. This is an abnormal accumulation of skin cells inside the ear, forming a lump. This lump can block the drainage of ear fluid, causing infection and leading to mastoiditis.
What are the symptoms of this?
You should be very concerned about these symptoms, especially if your child has recently had an ear infection.
| Symptom | Simply explained |
|---|---|
| Redness and swelling behind the ear | This is the main symptom. The bone behind the ear becomes dark red and very swollen. It hurts a lot when touched. |
| Ear thrust forward | The swelling behind the earlobe may appear to be pushed forward and down. |
| Discharge from the ear | A foul-smelling, yellow or green pus-like fluid may continue to drain from inside the ear. |
| Fever, malaise | An infection in the body can cause a high fever, body aches, and feeling too tired to do anything. Young children are often blindfolded. |
What are the dangerous conditions that can occur if left untreated?
This is what we should all be afraid of the most. If we think it's just an earache, the infection can spread and cause very serious, even life-threatening complications.
| Complication | Simply explained |
|---|---|
| Hearing Loss | The infection can damage the delicate parts of the ear and cause permanent hearing loss. |
| Facial paralysis | Because the nerve that controls facial muscles passes through this bone, the infection can spread and cause one side of the face to droop. |
| Meningitis or brain abscess | The infection can spread into the skull, causing meningitis or brain abscess. This is life-threatening. |
| Vertigo | If the infection spreads to the parts of the ear that are related to the body's balance (Labyrinthitis), severe dizziness and vomiting may occur. |
| Blood Clots | Very rarely, blood clots can form in the blood vessels of the brain, causing symptoms such as vision changes and severe headaches. |
How do you find this, Doctor?
If you or your child has an earache accompanied by fever, pain, redness, or swelling behind the ear, see a doctor immediately. The doctor will first examine the inside of the ear with an instrument called an otoscope. Mastoiditis is rare without a middle ear infection.
Then, a sample of the ear fluid can be taken and sent for a laboratory test (culture) to find out exactly what bacteria is causing the infection.
If there is a suspicion that the condition is serious, or if complications are suspected, you will be referred for a CT scan . This can clearly see the condition of the mastoid bone and the surrounding area. If there is something like a cyst somewhere, it must be removed and treated.
What are the treatments for this?
The main treatment for this is antibiotics .
Usually, if you are diagnosed with mastoiditis, you or your child will need to be hospitalized for treatment. There, you will be seen by an ear, nose, and throat specialist (ENT specialist). Antibiotics will be given through a syringe (IV - Intravenous) to quickly control the infection.
In addition, a minor surgery called a myringotomy can be performed to remove pus from the middle ear. This involves making a very small hole in the eardrum and draining some of the pus through it. Sometimes, a small tube is placed inside the hole to keep it open. This tube will fall out on its own within 6-12 months.
If IV antibiotics do not provide a quick cure, or if there are complications such as an abscess or bone loss, a mastoidectomy may be necessary. This involves surgically removing the infected part of the mastoid bone.
Don't forget, if the disease is diagnosed early and treated with the right antibiotics and, if necessary, surgery, all of these serious complications can be prevented and a full recovery can be achieved.
Take-Home Message
- Mastoiditis is a serious infection of the bone behind the ear. The main cause of this is a middle ear infection that has not healed properly.
- The main symptoms are swelling behind the ear, redness, severe pain, fever, and discharge from the ear.
- Never ignore these symptoms, especially in young children.
- The best thing to do when you see a symptom like this is to see your doctor immediately.
- The sooner treatment begins, the less likely it is to develop dangerous complications such as hearing loss and meningitis.
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