Overview
What is the pathophysiology of acute mastoiditis?
What is the pathophysiology of chronic mastoiditis?
What are the stages of mastoiditis disease progression?
What is a possible complication of mastoiditis surgery?
What is the relationship between acute otitis media (AOM) and mastoiditis?
How is culture performed for the diagnosis of mastoiditis?
Which lab tests are used in the workup of suspected mastoiditis?
What are surgical options for the treatment of mastoiditis?
What is the role of antibiotics in the treatment of acute surgical mastoiditis (ASM)?
Which host factors may contribute to the etiology of mastoiditis?
What age group is at highest risk for mastoiditis?
Which anatomical factors increase the risk of mastoiditis?
What is the role of autism in the etiology of mastoiditis?
Which pathogens may increase the risk for mastoiditis?
What is the most common cause of surgical mastoiditis?
What is the role of Streptococcus pneumoniae in the etiology of mastoiditis?
What is the incidence of surgical mastoiditis in the US?
Which population is at increased risk for mastoiditis?
What is the incidence of mastoiditis in European nations?
How does the prevalence of acute mastoiditis vary by age?
What are the possible complications of mastoiditis?
What is the prognosis of acute surgical mastoiditis (ASM)?
What is the likelihood of permanent conductive hearing loss in mastoiditis?
Where might the infectious process of mastoiditis extend?
What are intracranial complications of mastoiditis?
What has reduced the incidence of otogenic meningitis in mastoiditis?
What are the common complications of acute mastoiditis?
How does age affect the risk of complications in acute mastoiditis?
Presentation
How does fever present in mastoiditis?
What is the history characteristic of mastoiditis?
How does pain present in mastoiditis?
What should be the focus of history in infants with suspected mastoiditis?
What is the mean interval from onset of illness to mastoiditis?
What has caused an increase in the incidence of acute mastoiditis in infants?
What is the most consistent sign of acute surgical mastoiditis (ASM)?
What is the role of CT scanning in the diagnosis of mastoiditis?
Which findings on otoscopy are characteristic of mastoiditis?
What are the symptoms of mastoiditis in adults?
DDX
Which conditions should be included in the differential diagnoses of mastoiditis?
How is lateral sinus thrombosis identified in mastoiditis?
What are the differential diagnoses for Mastoiditis?
Workup
How does early diagnosis of acute mastoiditis improve outcomes?
What is the role of culture in the diagnosis of mastoiditis?
What is the role of complete blood count (CBC) in the diagnosis of mastoiditis?
What is the role of audiometry in the diagnosis of mastoiditis?
What is the role of tympanocentesis in the diagnosis of mastoiditis?
What is the role of myringotomy in the diagnosis of mastoiditis?
What is the role of imaging in the diagnosis of mastoiditis?
Which findings on CT scan are used to differentiate the type of mastoiditis?
When is CT unnecessary in the diagnosis of mastoiditis?
What is the role of MRI in the diagnosis of mastoiditis?
What is the role of radiography in the diagnosis of mastoiditis?
Treatment
How effective is treatment for acute mastoiditis?
Which surgical therapies are used for the treatment of mastoiditis?
When are antibiotics used in the treatment of mastoiditis?
How are complications of acute mastoiditis without osteitis or periostitis managed?
What are the treatment options for mastoiditis with osteitis?
How are antibiotics selected in the treatment of acute mastoiditis with osteitis?
What are the treatment options for mastoiditis that has spread?
What are the treatment options for acute mastoiditis with periostitis?
What are the transfer indications during treatment for mastoiditis?
What is the treatment approach to mastoiditis when transfer for specialized care is not possible?
Which specialist consultations are needed for the management of mastoiditis?
What is included in the monitoring of mastoiditis?
What is the role of antibiotics in the treatment of acute surgical mastoiditis (ASM)?
What is the role of steroids in the treatment of mastoiditis?
What are indications for medications in the treatment of mastoiditis?
What is the role of myringotomy and tympanocentesis in the treatment of mastoiditis?
How is a tympanostomy tube used in surgery for mastoiditis?
What is first-line surgery for abscesses in mastoiditis?
How is mastoidectomy performed for the treatment of mastoiditis?
When is mastoidectomy indicated for the treatment of mastoiditis?
What are the preoperative details for mastoidectomy to treat mastoiditis?
Where is the incision site for mastoidectomy to treat mastoiditis?
How is the mastoidectomy incision made for the treatment of mastoiditis?
What is the purpose of elevating the periosteum in mastoidectomy for the treatment of mastoiditis?
How is mastoidectomy drilling performed for the treatment of mastoiditis?
How is the mastoid cortex removed during mastoidectomy for mastoiditis?
How is the antrum gauged during mastoidectomy for the treatment of mastoiditis?
How is mastoid clearance performed during mastoidectomy for the treatment of mastoiditis?
How is the wound closed following mastoidectomy for mastoiditis?
How is facial nerve preserved during surgery for mastoiditis?
Which steps reduce the risk of conductive hearing loss following surgery for mastoiditis?
What are possible complications of mastoidectomy for mastoiditis?
What causes persistent deafness following mastoidectomy for mastoiditis?
What are signs of facial nerve damage following mastoidectomy for mastoiditis?
How is meatal stenosis managed during mastoidectomy for mastoiditis?
Which are less common complications of mastoidectomy for mastoiditis have been reported in children?
Medications
Which medications are used in the treatment of mastoiditis?
What are the alternative treatments to mastoid surgery for mastoiditis?
Which medications in the drug class Antipyretics are used in the treatment of Mastoiditis?
Which medications in the drug class Antibiotics, Otic are used in the treatment of Mastoiditis?
Which medications in the drug class Antibiotics, Other are used in the treatment of Mastoiditis?
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Mastoiditis with subperiosteal abscess. Note the loss of the skin crease and the pointed abscess.
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Cortical mastoidectomy in a densely sclerosed mastoid.
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Preoperative preparation of the patient.
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Draping the surgical area.
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Injection of the area with 2% Xylocaine and 1:100,000 adrenaline to reduce bleeding.
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Marking the incision site.
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Placement of the incision, a few mm behind the postauricular sulcus.
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Deepening the incision down to the bone.
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Elevation of the periosteum to expose the mastoid cortex to the mastoid tip.
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Mastoid drilling in progress with simultaneous saline irrigation.
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Creation of the initial groove and the vertical line.
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Exposure of the antrum and exenteration of the mastoid air cells.
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Curetting the aditus to enlarge it.
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Further exposure.
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Healed postaural scar.
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Extent of cortical mastoidectomy in a well-pneumatized mastoid.