acute mastoiditis lecture
DESCRIPTION
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ENT - BBH
ACUTE MASTOIDITIS
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DEFINITION
It is the inflammation of mucosal lining of antrum and mastoid air cells system.
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Etiology
Age
Socio economic group
Organism virulence
Immunocompromised
Cholesteatoma
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Pathology
Production of pus under tension
Hyperaemic decalcification
Osteoclastic resorption of bony walls
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ROUTES OF SPREAD
Direct bone erosion
Venous thrombophlebitis
Petrosquamous suture
Oval or round windows
Internal auditory meatus
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Clinical Features
Symptoms:
Earache
Fever
Ear discharge
Signs:
Mastoid tenderness
Sagging of posterosuperior meatal wall
TM perforation
Swelling over mastoid
Hearing loss
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Investigations
Blood CP
X-ray mastoids
CT scan temporal bones
Ear swab for c/s
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Differential Diagnosis
Suppuration of mastoid lymph nodes
Furunculosis of meatus
Infected Sebaceous cyst
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TREATMENT
Medical treatment
Hospitalize
Antibiotics
Analgesics
Surgical treatment
Myringotomy
Cortical mastoidectomy
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COMPLICATIONS
Subperiosteal abscess
Labyrinthitis
Facial paralysis
Petrositis
Extradual abscess
Subdural abscess
Meningitis
Brain abscess
Lateral sinus thrombophlebitis
Otitic hydrocephalus
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Post-auricular abscess
Zygomatic abscess
Bezold abscess
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MASKED (LATENT) MASTOIDITIS
Slow destruction of mastoid air cells
No pain, discharge, fever, mastoid swelling
Mastoidectomy shows extensive destruction of air cells with granulation tissue
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