Mastoiditis - an inflammation, followed by purulent fusion of the mastoid area of the temporal bone in the region.
Mastoid - a special zone in the region of the skull bones associated with the cavity of the middle ear and performs the role of the duct and the cavity. Therefore, usually a complication of mastoiditis average otitisAnd rarely self-pathology.
general information
Mastoid is a place of attachment of muscles, turns his head to the side. It is located behind the ear, a little downward and slightly sticks out if its probe. Inside filled mastoid bone partitions in the form of cells, but such a structure it gets as far as the body's growth, by about six years.
At this age there are typical manifestations of destructive processes in the periosteum and bone tissue process. From the cranial cavity mastoid fenced off by a thin plate of bone, making an inflammatory process in the zone of very dangerous.
Kinds
On occurrence of infection are different:
- primary mastoiditis, with the original hit inflammatory agent in the mastoid cavity,
- secondary mastoiditis occurring as a complication of inflammatory processes of the body.
Secondary mastoiditis may occur:
- as a result of otitis media, it is called otogenny,
- as a result of head injuries,
- as a focus for the flow of sepsis (septikopiemichesky hearth).
Adrift mastoiditis can be:
- typical, with the presence of all the classic symptoms,
- Atypical or latency, sluggish flowing inflammation without obvious symptoms.
Causes
When mastoiditis infection is mainly microbial penetrating from the middle ear. Most often it happens pneumococcal flora, staphylococcal or Haemophilus influenzae. Less common fungal (otomycosis).
There may also be:
- tramatichesky mastoiditis (with bumps, bruises, wounds),
- transition of infection with a number of underlying lymph nodes,
- tuberculous lesion,
- granulomas in the process.
development mechanism
At the first stage of the process - exudative occurs mucositis and periosteum, filling the cavity with pus. As the transition to the second stage - alterative, bone destruction occurs partitions, filling the cavity with granulation, connective tissue growths, purulent forms a single cavity. In complicated pus melts and breaks the back plate to the meninges.
manifestations of mastoiditis
Mastoiditis phasically flows, are the two stages of the disease:
- exudative,
- alterative (destructive).
In the exudation stage is the formation of the inflammatory process in the process, and typically is not much different from the average acute manifestations otitis. The most common processes are developing in parallel. occur
- sharp pain in the ear,
- headache, especially when head movements,
- high fever with temperatures up to 40 degrees,
- discharge from the ear, which arise spontaneously or following medical membrane perforation.
If there is no adequate treatment for this stage of otitis media and mastoiditis, too early canceled antibiotics and there is no outflow of pus, the symptoms of deterioration occur:
- again observed temperature jump,
- pus from the ear is very thick,
- there is a sharp pain in the ear, especially the ear,
- behind the ear there is redness,
- within the process at this time pus destroys the walls and accumulates.
The second stage is characterized by mastoiditis breakthrough of pus in any space:
- pus penetrates under the periosteum, the skin and breaks out. This forms the redness, increased purulent cavity and opens outwardly fistula over pus
- pus may break in the inner ear area. Labyrinthitis formed with vertigo, tinnitus, and hearing loss, twitching eyeballs
Diagnostics
In a typical symptoms mastoiditis diagnosis is based on clinical manifestations, but with atypical current diagnosis is difficult. Additional studies:
- general and biochemical blood tests,
- X-rays of the head and mastoid, painting with patches of melting and purulent cavity,
- If necessary, a MRI or CTTo clarify complications.
It is important to distinguish from mastoiditis boil in the rear wall of the auditory meatus.
treatment of mastoiditis
Diagnosis and treatment of mastoiditis engaged ENT doctors. Require hospitalization to the department of otolaryngology. Apply conservative and surgical treatment.
When conservative appoint:
- antibiotics intramuscularly or intravenously,
- creating outflow of pus from the ear (or myringotomy independent membrane autopsy)
If this treatment is not successful within 1-2 days, the operation is prescribed. This involves:
- autopsy bone partitions in the mastoid area behind the ear, with the tools or use specific drugs to remove affected tissue.
- placed drainage tube to drain pus,
- washing purulent cavity,
- introduction into the cavity anti-inflammatory drugs.
Delays in treatment of mastoiditis in grave complications, or in the best of cases - the transition to a chronic form with a complex treatment.
complications
The most serious complications are mastoiditis lesion of the facial nerve:
- facial asymmetry occurs,
- angle of the mouth or eye drops down,
- the face is like a mask,
- bad eyelid closes.
Another dangerous complication of mastoiditis is becoming a breakthrough of pus in the cranial cavity with the formation of the inflammation of the meninges, or brain matter. Thus there are general symptoms of infection:
- fever with blood inflammatory changes,
- sleep disturbance and appetite,
- nausea and even vomiting,
- refusal to eat because of pain in the ear.
