Mastoiditis

Introduction It is an acute suppurative inflammation of the mucosa and bone of the mastoid air chamber, which is mostly developed from acute suppurative otitis media. Children are more common in the body's weak resistance, the pathogenic virulence, or improper treatment, so that the middle ear inflammation continues to develop, the entrance of the sinus is blocked by the swollen mucosa, the pus drainage in the mastoid is not smooth, accumulate in the mastoid In the air chamber, the mucous membrane of the air chamber is necrotic and detached. The bone wall is affected by pus hydraulic pressure and autoinflammatory lesions. Decalcification and necrosis occur, the septum is broken, and the air chamber is fused to form a large abscess. Mastoid or mastoid pus. If acute mastoiditis caused by hemolytic streptococcus or influenza bacilli, the wall of the mastoid bone remains intact, and the air chamber is filled with bloody secretions, called hemorrhagic mastoiditis.

Cause

It is more common in children's pathogenic bacteria, the patient's resistance is low, the patient's resistance is low, the otitis media is not treated in time or the middle ear is not smooth, which is the cause of the disease. The infection spreads to the mastoid, causing empyema in the air chamber, osteonephrosis and necrosis. The clinical symptoms are more severe than acute suppurative otitis media, or the symptoms are not relieved after ear pus, the redness and tenderness of the mastoids after the ear, X-ray mastoids can help diagnosis.

an examination

Related inspection

Mastoid CT examination

Routine examination of mastoiditis If the mastoiditis patient needs to undergo a mastoiditis surgery, the box limits "A" and "B" are required. The suspected intracranial complication should be "C". If the symptoms of the tympanic membrane perforation of the tympanic membrane are more serious due to mastoiditis, the X-ray film or CT scan should be performed. The audiology and X-ray examination are more helpful in diagnosing the condition.

Differential diagnosis

(1) The main symptoms of acute suppurative otitis media, such as fever, earache, hearing loss, pus in the ear, etc. in the perforation of the tympanic membrane, the purulent secretion in the middle ear should disappear soon after the flow, but if in the perforation 1 After ~2 days, the symptoms that have already subsided reappeared or become more serious. Children with severe gastrointestinal symptoms such as vomiting and diarrhea should consider the possibility of acute mastoiditis.

(2) The skin of the mastoid is swollen and flushed, and there is obvious tenderness.

(3) The posterior superior wall of the external auditory canal is red and swollen, and the perforation of the tympanic membrane is small. There are pus pulsations in the perforation, and the amount of pus is high. Sometimes the pus penetrates the outer wall of the mastoid and forms an abscess under the periosteum.

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