Mastoiditis is a bacterial infection that affects the mastoid bone.
The mastoid bone is the part of your skull just behind your ear. Mastoiditis is not common but happens more in children.
With early diagnosis and treatment mastoiditis does not usually have complications.
Symptoms of mastoiditis
Mastoiditis usually happens after a middle ear infection.
Symptoms of mastoiditis include:
- redness, tenderness and pain behind the ear
- swelling behind the ear that may cause the ear to stick out
- fluid coming from the ear
- a high temperature
- irritability and tiredness
- headache
- hearing loss in the affected ear
Non-urgent advice: Contact your GP as soon as possible if
you or your child has:
- symptoms of mastoiditis
- an ear infection that does not improve with treatment
- an ear infection and new symptoms appear
- mastoiditis that does not improve with treatment
Causes of mastoiditis
Mastoiditis happens when air spaces in the mastoid bone become infected or inflamed.
Causes include:
- middle ear infections (otitis media)
- a growth or lump of skin cells in the ear (cholesteatoma) - the lump stops the ear draining well
Diagnosing mastoiditis
Your GP will look in your ear with a device called an otoscope.
If your GP thinks you have mastoiditis, they may refer you for tests:
- in an emergency department (ED)
- with an ear, nose and throat (ENT) specialist
Tests usually include a blood test and an ear culture test. In an ear culture test, a lab checks fluid from the ear for a bacterial infection.
Sometimes you may need a CT scan (computerised tomography scan). A CT scan uses x-rays and a computer to create detailed images of the inside of the skull.
Treating mastoiditis
Mastoiditis needs quick treatment with antibiotics.
You may need to go to hospital to get antibiotics directly into a vein, through a drip.
In some cases, you may need surgery to either:
- drain the middle ear - this is called a myringotomy
- remove part of the mastoid bone - this is called a mastoidectomy
You may need to stay in hospital for a few days to get the infection under control.
After surgery
Your doctor will give you follow-up appointments and explain how to care for your ear.
After surgery for mastoiditis, you need to:
- keep your ear dry
- wait at least 1 week before you wash your hair and avoid getting water in your ear
- wait 4 to 6 weeks to go swimming depending on how well your ear heals
You may need to rest at home for 1 to 2 weeks to recover.
Complications of mastoiditis
Most people with mastoiditis do not get serious complications. But sometimes the infection comes back.
Serious complications of mastoiditis are rare but can include:
- hearing loss
- a blood clot
- meningitis
- a brain abscess
