1. MASTOIDITIS
INTRODUCTION
The mastoid process is the portion of the temporal bone of the skull that is behind
the ear which contains open, air-containing spaces.
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.
CLASSIFICATION
1. Acute mastoiditis: It is a rare complication of acute otitis media.
2. Chronic mastoiditis: It is most commonly associated with CSOM or with
cholesteatoma formations.
CAUSES & RISK FACTORS
1. Infection of the middle ear.
2. Injury of the mastoid bones and cells.
3. Cholesteatoma.
4. Upper respiratory infection.
SIGNS AND SYMPTOMS
1. Otalgia.
2. Swelling on the mastoid bone.
3. Perforation of the ear drum.
4. Loss of hearing.
5. Severe pain at eating time.
6. Increased cranial pressure.
7. Painless discharge from the affected ear.
8. Otorrhoea(purulent discharge) may be odorless or foul smelling.
9. Nausea, vomiting.
2. PATHOPHYSIOLOGY
Due to infection of middle ear
Acute otitis media
Infection reaches at mastoid air cells
Inflammation of mastoid process
DIAGNOASTIC EVALAUTION
1. History collection.
2. Physical examination.
3. Mastoid bone x ray.
4. CT scan.
5. Lab: CBC, DLC, Blood culture, tympanocentesis.
6. Audiography.
MEDICAL MANAGEMENT
1. Antibiotic and steroid eardrop for infection and inflammation, e.g.
Ciplox-D.
2. Ear-irrigation: For removing purulent discharge.
3. Analgesics drugs: Aspirin, Nimuslide.
SURGICAL MANAGEMENT
1. Mastoidectomy: It is a surgical procedure that removes diseases
mastoid air cells.
2. 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.
3. Tympanoplasty: also called eardrum repair. It is the surgical
reconstruction of the perforated eardrum or the small bones of the
middle ear.
NURSING MANAGEMENT
Assess pain for location, intensity etc.
Administer analgesics as prescribed to relieve pain.
3. Administer antibiotics as ordered.
Administer antipyretics as prescribed.
Provide plenty of fluids.
Use coolwater sponging to reduce bodytemperature,
Encourage patient and family to use signs of non verbal
communication such facial expression, pointing, bodymovement.
NURSING DIAGNOSIS
High risk for infection relate to tissue destruction.
Pain relate 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 realted to balance difficulty.
