Mastoiditis is an inflammation in the mucous membrane and hard tissue of the temporal bone. Everyone can easily feel this anatomical structure behind the ear. Ear mastoiditis in adults and children is the result of the spread of an infection that originally arose in the internal anatomical structures of the organ of hearing. The disease is dangerous and fraught with serious complications.
Let's consider what mastoiditis is, what causes it, how the pathology manifests itself, and what methods are used to treat the disease in the K + 31 Clinic.
Causes
The direct cause of the pathology is the penetration of pathogenic microorganisms into the mucous, connective and hard tissues of the mastoid process. These are often the same disease-causing agents that cause otitis media (otitis media). It is otitis media that is usually the primary pathology. By itself, mastoiditis rarely develops.
A specific pathogen can be identified only after laboratory diagnosis, but in most clinical situations it is:
- Pneumococci;
- Streptococci;
- Staphylococci;
- Gram-negative bacteria.
Pseudomonas aeruginosa and anaerobic microbes are less common. Regardless of the type of infectious agent, the inflammatory process is accompanied by a local reaction of the body to a foreign invasion. A characteristic sign of acute mastoiditis is the presence of pus, which indicates the activity of leukocytes. A frequent indirect cause of the development of the disease is inadequate or inadequate treatment of otitis media (therapy with alternative methods without medical supervision).
Pathogenesis of mastoiditis
Inflammation develops rapidly in the acute form of the disease and gradually in the chronic one.
Pathology proceeds in 2 stages:
- In the debut stage, the mucous membranes and periosteum are actively involved in the process, which leads to the filling of tissues with exudate (fluid from microscopic blood vessels), their inflammation and thickening.
- The second stage is also called destructive - it is characterized by damage and destruction of bone tissue. The internal structures of the bone undergo necrosis (death) - this situation is fraught with the emergence of dangerous pathological processes in the tissues of the skull. The outflow of pus into the internal cavities causes the formation of abscesses that require surgical intervention.
Mastoiditis is more often diagnosed in patients with pneumatic anatomical type of mastoid process. Additional factors affect the development of the disease:
- Increased virulence (aggressiveness and vitality) of bacterial colonies;
- Lowered immune status against the background of other chronic diseases;
- Taking medications - strong antibiotics, chemotherapy drugs;
- Having diabetes.
The primary task of a doctor with mastoiditis is to stop inflammation at the initial stage of its development, but patients do not always go to the clinic at the onset of pathology, which complicates therapy.
Classification of mastoiditis
Localization distinguishes between right-sided mastoiditis and left-sided. Less commonly, bilateral mastoiditis develops - this is an inflammatory process of a symmetrical nature, caused by extensive damage by infectious agents.
According to the etiology, 5 types of mastoiditis are distinguished.
Primary - which develops directly in the temporal bone without otitis media and inflammation in the structures of the hearing organs. This is a rare type of disease and very dangerous.
Secondary is the most common variant that develops as a complication of otitis media.
Otogenic - caused by the spread of the inflammatory process directly through the internal structures of the hearing organs.
Hematogenous - in which infectious agents reach the site of inflammation through the circulatory system. With this type of disease, the primary inflammatory focus occurs both in the ear and in other parts of the body.
Traumatic - developing as a result of traumatic injuries - craniocerebral trauma, blows, bruises. In this case, bacterial agents penetrate directly through the open wound.
Symptoms of mastoiditis
With the disease, local and general symptoms develop.
Common ones include:
- Heat;
- Weakness, decreased performance;
- An increase in the number of leukocytes, an increase in ESR and other signs of an inflammatory reaction;
- Decreased appetite, insomnia.
Local symptoms are pain in the ear and in the temporal bone, a change in the position of the auricle, the flow of pus from the ear. Sometimes there is no discharge of pus because there is no way for it to drain. The manifestations of the disease occur 7-14 days after the onset of otitis media. The dynamics of pathological processes in inflammation of the middle is important in the diagnosis of the disease.
Sometimes mastoiditis develops without fever: this situation is typical for elderly and debilitated patients. Symptoms of mastoiditis in children are more intense, especially in infancy.
Outwardly, the disease manifests itself in the form of hyperemia and thinning of the skin in the area of the mastoid process. Suppuration is pulsating in nature, as well as pain. The purulent mass fills the ear opening immediately after cleaning it. With the progression of the pathology, the integrity of the tympanic membrane is often violated, which leads to temporary hearing loss.
In the later stages of the disease, the bony septa of the mastoid process are destroyed, and the internal cavities are filled with pus. Breakthroughs of purulent foci into the surrounding soft tissues are observed, as a result of which additional abscesses (closed foci) are formed. Sometimes pathological manifestations extend to the area of the neck from the side of inflammation: this variant of the disease is called "Bezold's mastoiditis". This variety is characterized by pain when turning the head and provokes the development of lymphadenitis.
Complications
The consequences of the disease are very dangerous:
- Hearing loss and complete hearing loss;
- Intracranial diseases - meningitis, abscesses of the brain and cranial cavities;
- Paralysis of the facial muscles.
The prognosis of treatment directly depends on its timeliness. The earlier therapy is started, the lower the risk of complications and concomitant diseases. The most appropriate option when the first symptoms of the disease are detected is to go to a professional-level clinic. In the International Medical Center "Clinic K + 31", patients are received seven days a week.
Diagnostics
In typical clinical situations, mastoiditis is not difficult to diagnose. The disease is detected by external examination, palpation and endoscopy of the auricle. However, with atypical development of the disease, additional studies are needed: CT, MRI, X-ray.
The MRI method for mastoiditis determines the localization of purulent foci, the outflow of which is impaired. Imaging methods show the degree of intensity of inflammatory processes and detect destructive changes in bone tissue.
If doctors do not know the causative agents of the disease, a bacterial culture of purulent discharge from the ear is performed. Determination of the exact type of pathogenic microflora is necessary for the appointment of targeted drug therapy.
Treatment of mastoiditis
Therapy of this dangerous and insidious disease in the international clinic "Clinic K + 31" is carried out in a comprehensive manner. How to treat mastoiditis, the doctor decides on the basis of the diagnosis and clinical picture. At the first stage of treatment, medicinal methods are practiced - intravenous administration of antibiotics, treatment of foci with anti-inflammatory and antiseptic drugs. Most often, treatment is carried out in a hospital.
Since you need to act quickly at the initial stage, broad-spectrum antibiotics are prescribed. After receiving the results of bacteriological culture, drug therapy is adjusted - more specific antibiotic drugs are selected.
If treatment with antimicrobial drugs does not give a quick result, surgery is performed - opening and cleaning the purulent cavities. The most common procedure is to enter the problem area through a small incision in the tympanic membrane and insert a special tube to drain the pus. After a certain time, the eardrum heals, the tube is pushed out of the organ of hearing naturally.
The occurrence of complications requires more serious operations. Destruction of bone structure and tissue necrosis - indications for a mastoidectomy - excision of a part of the bone along with a cavity containing purulent exudate. The internal structures of the ear are cleared of pus residues. Surgical treatment is prescribed immediately if the patient is diagnosed with stage 2 of the disease at the initial appointment.
Other unconditional indications for urgent surgical intervention:
- Complications in nearby areas;
- The formation of deep purulent foci;
- Development of inflammation of the temporal bone;
- Paresis and paralysis of the facial nerve.
For children under 3 years of age, the absence of a developed mastoid process is characteristic, and therefore the operation is somewhat different and is called "antrotomy". Radical interventions are performed either under general endotracheal anesthesia (drugs enter the bloodstream through a thin tube inserted into the respiratory system), or under local anesthesia (in adults).
After the operation, antibiotic treatment is continued, in parallel, vitamin and restorative therapy is carried out. The wound is treated daily with antiseptics, then wound-healing local preparations are used. To speed up the healing process, physiotherapeutic procedures are also prescribed - ultraviolet irradiation, laser therapy. Complete recovery after surgery occurs in 3 weeks.
The best way to prevent mastoiditis is to treat inflammatory diseases of the middle ear in a timely manner. If competent antibiotic therapy has been carried out in a clinical setting, then the further spread of the infection will not occur.
If the first symptoms of otitis media and mastoiditis occur, you should immediately contact the IMC "Clinic K + 31", where adequate and effective therapy will be carried out as soon as possible. Professional doctors strongly advise not to self-medicate for inflammatory and infectious diseases, but to seek qualified and competent help.
