4. • Definition- Inflammation of mucosal lining of antrum
and mastoid air cell system
• Aetiology-Beta hemolytic streptococcus
• Pathology-
1) Production of pus undertension
2) Hyperaemic decalcification and osteoclastic resorption
of bony walls
ACUTE MASTOIDITIS
5. CLINICAL FEATURES
Symptoms
1) Pain behind the ear
2) Fever and ear discharge
Signs
1) Mastoid tenderness
2) Ear discharge
3) Sagging of postero-superior meatal wall
4) Perforation of tympanic membrane
5) Swelling over the mastoid
6) Hearing loss-conductive type
6. Investigations
• Blood count
• ESR
• X ray mastoid
• Ear swab
Treatment
• Hospitalization of patients
• Antibiotics
• Myringotomy
• Cortical mastoidectmy
7. • Abscesses in relation to mastoid infection
1. Post auricular abscess
2. Zygomatic abscess
3. Bezold abscess
4. Luc abscess
5. Citelli’s abscess
6. Para ( or) Retropharyngeal
abscess
8. • Definition-spread of infection from middle ear and mastoid
to the petrous part of temporal bone
• Clinical features-
1. Gradenigo syndrome- 5th nerve involvement,6th nerve
palasy,persistent ear discharge
Fever,headache,vomitings,sometimes neck rigidity may
also be associated with it
• Investigations- CT and MRI
• Treatment - Mastoidectomy
PETROSITIS
9. • FACIAL PARALYSIS- It occurs as a complication of
both acute and chronic otitis media.
• LABYRINTHITIS- There are three types-
1. Circumscribed labyrinthitis
2. Diffuse serous labyrinthitis
3. Diffuse suppurative labyrinthitis
10. ◦ EXTRA DURAL ABSCESS- Collection of pus between the
bone and dura
Persistent headache
Severe pain in ear
Purulent discharge.
◦ SUBDURAL ABSCESS-Collection of pus between dura
and arachnoid
Meningeal irritation
Raised intracranial tension
Cortical venous thrombophlebitis
11. Definition-It is the inflammation of leptomeninges(most common
intracranial complication)
• Clinical features-
Symptoms
1. Fever with chills and rigor
2. Headache ,neck rigidity
3. Photophobia and mental irritability
Signs
1. Kernig’s sign
2. Brudzinski’s sign
3. Papilloedema
MENINGITIS
12. • Investigations-
1. lumbar puncture and CSF examination
2. CT or MRI
• Treatment-
Medical-antimicrobial therapy and corticosteroids
Surgical- myringotomy and mastoidectomy
13. Definition- It is the inflammation of the inner wall of lateral venous
sinus with formation of an intra sinus thrombus.
• Bacteriology-
1. In acute-hemolytic streptococcus,pneumococcus,or staphlococcus
2. In chronic –bacillus proteus,pseudomonas,E.coli and staphylococci
• Pathology-
1. Formation of perisinus abscess
2. Endophlebitis and mural thrombus formation
3. Obliteration of sinus lumen and intra sinus abscess
4. Extension of thrombus
LATERAL SINUS THROMBOPHLEBITIS
14. i. Hectic picket fence type of fever with rigors
ii. Headache
iii. Progressive anemia and emaciation
iv. Griesinger’s sign
v. Papilloedema
vi. Tobey-ayer test
vii. Crowe beck test
viii.Tenderness along jugular vein
Clinical features
15. • Investigations-
1. blood smear and blood culture
2. CSF examination
3. X ray mastoids
4. CT and MRI scans
5. Culture and sensitivity.
• Treatment-
1. IV antibacterial therapy
2. Mastoidectomy
3. Ligation of internal jugular vein
4. Supportive treatment
16. • It is characterized by raised intracranial pressure with
normal CSF findings.
• Clinical features
Symptoms
1. Severe headache
2. Diplopia
3. Blurring of vision
Signs
1. Papilloedema
2. Nystagmus
◦ Treatment- acetazolamide and corticosteroids
OTITIC HYDROCEPHALUS
