INFLAMMATION OF THE MASTOID PROCESS

1. MASTOIDITIS
SUDESHNA BANERJEE DUTTA
SENIOR LECTURER
S.R.S.V.M B.Sc (N) COLLEGE

2. INTRODUCTION
➢ The Mastoid process is an inferior extension
of the temporal bone which contains open,
air-containing spaces
➢ Provides a structural function as an anchor
point for large muscles of the neck

3. DEFINITION
➢ It is an inflammation of the mastoid
process behind the ear and of the air
space connecting it to the cavity of the
middle ear.

4. CLASSIFICATION
➢ Acute mastoiditis: It is a rare
complication of acute otitis media.
➢ Chronic mastoiditis: It is most
commonly associated with CSOM or
with cholesteatoma formations.

5. CHOLESTEATOMA

6. CAUSES & RISK FACTORS
➢ Infection of the middle ear
➢ Injury of the mastoid bones and cells
➢ Cholesteatoma
➢ Upper respiratory infection

7. CAUSES & RISK FACTORS
➢ Streptococcus pneumonia 25% prevalence
➢ H. Influenza
➢ S. pyogenes
➢ Pseudomonas aeruginosa
➢ Moraxella Catarrhalis
➢ Aspergillus & other fungi (immuno-compromised
patients)

8. SIGNS AND SYMPTOMS
➢ Otalgia
➢ Swelling on the mastoid bone
➢ Perforation of the ear drum
➢ Loss of hearing
➢ Severe pain during eating
➢ Painless discharge from the affected ear
➢ Otorrhea (purulent discharge) may be odorless or
foul smelling
➢ Nausea, vomiting

9. PERFORATION OF THE EAR DRUM

10. PATHOPHYSIOLOGY
Due to infection of middle ear
Acute otitis media
Infection reaches at mastoid air cells
Inflammation of mastoid process
(mastoiditis)

11. DIAGNOSTIC EVALUATION
➢ History collection
➢ Physical examination
➢ X ray of Mastoid bone
➢ CT scan
➢ Lab: CBC, Blood culture, tympanocentesis
➢ Audiography
➢ If intracranial spread suspected, then go for LP

12. TYMPANOCENTESIS
➢ Tympanocentesis is the removal of
fluid from behind the eardrum. The
doctor uses a special needle with a
tube attached to collect the sample
of fluid.
➢ A culture and sensitivity test is
usually done on the sample of fluid.

14. MEDICAL MANAGEMENT
➢ Antibiotic and steroid eardrop for
infection and inflammation, e.g.
Ciplox-D
➢ Ear-irrigation: For removing purulent
discharge
➢ Analgesics drugs: Aspirin, Nimuslide.

15. EAR-IRRIGATION
➢If wax buildup is the issue,
your doctor will perform the
irrigation using a syringe-
like tool.
➢This tool will be used to
insert water or a water and
saline mixture into the ear
to flush out the wax.
➢ You may feel slight
discomfort from the water in
your ear

16. SURGICAL MANAGEMENT
➢ Mastoidectomy: It is a surgical procedure that
removes diseased mastoid air cells
➢ Myringotomy: It is a surgical procedure in which a
tiny incision is created in the eardrum relieves
pressure caused by excessive buildup of fluid or pus
➢ Tympanoplasty: also called eardrum repair. It is the
surgical reconstruction of the perforated eardrum or
the small bones of the middle ear.

17. MASTOIDECTOMY

18. MYRINGOTOMY

19. TYMPANOPLASTY

20. NURSING MANAGEMENT
➢ Assess pain for location, intensity etc
➢ Administer analgesics as prescribed to relieve
pain
➢ Administer antibiotics as ordered
➢ Administer antipyretics as prescribed
➢ Provide plenty of fluids
➢ Use cool water sponging to reduce body
temperature
➢ Encourage patient and family to use signs of non
verbal communication such facial expression,

21. NURSING DIAGNOSIS
➢ High risk for infection related to tissue destruction
➢ Pain related to physical factors
➢ Altered auditory sensory perception related to
partial/total perforation of tympanic membrane
➢ Impaired verbal communication related to hearing
deficit
➢ High risk for trauma related to impaired balance