2. DEFINITION
• It is the inflammation of mucosal lining of
antrum and mastoid air cells system.
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ENT - BBH
3. Etiology
• Age
• Socio economic group
• Organism virulence
• Immunocompromised
• Cholesteatoma
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ENT - BBH
4. Pathology
• Production of pus under tension
• Hyperaemic decalcification
• Osteoclastic resorption of bony walls
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ENT - BBH
5. ROUTES OF SPREAD
• Direct bone erosion
• Venous thrombophlebitis
• Petrosquamous suture
• Oval or round windows
• Internal auditory meatus
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ENT - BBH
6. Clinical Features
Symptoms:
Earache
Fever
Ear discharge
Signs:
Mastoid tenderness
Sagging of posterosuperior meatal wall
TM perforation
Swelling over mastoid
Hearing loss ENT - BBH
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8. Investigations
• Blood CP
• X-ray mastoids
• CT scan temporal bones
• Ear swab for c/s
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ENT - BBH
9. Differential Diagnosis
• Suppuration of mastoid lymph nodes
• Furunculosis of meatus
• Infected Sebaceous cyst
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ENT - BBH
10. TREATMENT
• Medical treatment
− Hospitalize
− Antibiotics
− Analgesics
• Surgical treatment
− Myringotomy
− Cortical mastoidectomy
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ENT - BBH
11. COMPLICATIONS
• Subperiosteal abscess
• Labyrinthitis
• Facial paralysis
• Petrositis
• Extradual abscess
• Subdural abscess
• Meningitis
• Brain abscess
• Lateral sinus thrombophlebitis
• Otitic hydrocephalus
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ENT - BBH
12. • Post-auricular abscess
• Zygomatic abscess
• Bezold abscess
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ENT - BBH
13. 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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ENT - BBH
