Chronic Mastoiditis

What is chronic mastoiditis?
Chronic mastoiditis is an inflammation and infection of the middle ear space that involves the mastoid bone located just behind the outer ear. Chronic mastoiditis is one of the leading causes of hearing loss after chronic ear infections.

What are the symptoms of chronic mastoiditis?
Symptoms include drainage from the ear, persistent, throbbing ear pain, fever that may be high or suddenly increase, headache, hearing loss, redness of the ear or behind the ear and swelling behind the ear that may cause the ear to stick out.

What are the causes of chronic mastoiditis?
The unique architecture and anatomic relationship of the mastoid bone to other ear structures make it particularly vulnerable with repeated ear infections. The mastoid bone is composed of many thousands of interconnected air chambers. When an infection reaches these chambers, they can become filled with fluid – an ideal environment for rapid growth of dangerous bacteria. Chronic mastoiditis usually stems from an untreated or inadequately treated middle ear infection that spreads to the mastoid bone.

The initiating infection may arise from earlier acute infections of the middle ear or cyst development inside the ear and is often associated with a perforated eardrum. Chronic mastoiditis usually follows a pus-producing infection of the middle ear that blocks normal drainage and aeration of the mastoid bone.

How is chronic mastoiditis diagnosed?
A physical exam of the head may identify signs of mastoiditis. Beyond that, a CT scan of the ear or a head CT scan may reveal an abnormality of the mastoid bone. A culture of drainage from the ear may show bacteria.

What is the conventional treatment for chronic mastoiditis?
Treatment begins with intravenous antibiotics, but these drugs may be taken orally for at least two weeks once recovery begins. However, when the infection and inflammatory process have been sufficiently controlled, surgery is often needed to remove the infected portion of the mastoid and when indicated, the eardrum and middle ear bones as well. The extent of the disease dictates the extent of surgery. While the long-term objective is to preserve or re-create the anatomy of the ear and retain hearing, the ultimate surgical goal is to create a “safe ear” that is free of disease and associated complications. Secondary operations are often performed later to reconstruct the hearing mechanism.

What therapies does Dr. Weil recommend for chronic mastoiditis?
Dr. Weil knows of no alternative therapies to treat mastoiditis, however, he emphasizes the need for good communication between patient and doctor. Evaluation and treatment of this disorder is an ongoing process that requires a supportive working relationship. (The best advice is to work with an integrative practitioner to prevent recurrent ear infections, which is what often leads to chronic mastoiditis.)