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Mastoiditis

Megan Finneran, MS, DO and Emilio Nardone, MD Reviewed 06/2020
 


BASICS

Mastoiditis is an inflammatory process of the mastoid bone. It is most commonly a complication of acute otitis media (AOM). 

DESCRIPTION

  • Clinical manifestations of mastoiditis typically appear da...

DIAGNOSIS

HISTORY

  • Most common symptoms in infancy

    • Lethargy/malaise/irritability

    • Fever

    • Poor feeding/decreased appetite

  • Recent ear infection

  • Otorrhea (drainage from an ear infection)

  • Otalgia and/or pain on mas...

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 or longer for intracranial complications)

  • For chronic mas...

REFERENCES

1
Psarommatis IM, Voudouris C, Douros K, et al. Algorithmic management of pediatric acute mastoiditis. Int J Pediatr Otorhinolaryngol.  2012;76(6):791–796.
2
Alkhateeb A, Morin F, Aziz H,...

ADDITIONAL READING

  • Cherry JD, Vahabzadeh-Hagh AM, Shapiro NL. Mastoiditis. In: Cherry JD, Demmler-Harrison GJ, Kaplan SL, et al., eds. Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia,...

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.

  • Temporal bone CT is best diagnostic tool, use only when mastoiditis is suspected to limit radia...

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