Mastoiditis

Renata Scalabrin Reis, MD and Cristian Fernandez Falcon, MD, DABFM, CAQGM, CAQHPM, CMD Reviewed 06/2018
 


BASICS

An inflammatory process of the mastoid air cells and/or posterior process of the temporal bone, most commonly a suppurative complication of acute otitis media (AOM) 

DESCRIPTION

  • Clinical manifest...

DIAGNOSIS

HISTORY

  • Most common symptoms in infancy (1)[A]

    • Lethargy/malaise/irritability

    • Fever

    • Poor feeding/decreased appetite

  • Otalgia/possible otorrhea

  • Hearing loss

  • Headache

  • Pain/redness/swelling noted over ...

TREATMENT

  • IV antibiotics and myringotomy (± tympanostomy tubes) is the preferred treatment for uncomplicated acute mastoiditis (reflecting a shift away from more invasive surgical treatment).

  • To avoid ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Oral antibiotics for 3 weeks following course of IV antibiotics (total duration of antibiotics is 4 weeks)

  • For chronic mastoiditis, consider several months of anti...

REFERENCES

1 van den Aardweg MT, Rovers MM, de Ru JA, et al. A systematic review of diagnostic criteria for acute mastoiditis in children. Otol Neurotol.  2008;29(6):751–757.  [View Abstract]
2...

ADDITIONAL READING

  • Minks DP, Porte M, Jenkins N. Acute mastoiditis—the role of radiology. Clin Radiol.  2013;68(4):397–405.  [View Abstract]

  • Pritchett CV, Thorne MC. Incidence of pediatric acute ...

CODES

ICD10

  • H70.90 Unspecified mastoiditis, unspecified ear

  • H70.009 Acute mastoiditis without complications, unspecified ear

  • H70.099 Acute mastoiditis with other complications, unspecified ear

  • H70.10 Chro...

CLINICAL PEARLS

  • Suspect mastoiditis if symptoms of AOM persist >2 weeks despite a normal-appearing TM.

  • Hospitalize patients with acute mastoiditis for IV antibiotics. Consult ENT for drainage proced...

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