Otolaryngology Book

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Mastoiditis

Aka: Mastoiditis
  1. Epidemiology
    1. Rare now since the use of antibiotics in Otitis Media
  2. Pathophysiology
    1. Extension of middle ear disease
    2. Abscess and destruction of mastoid bone
  3. Predisposing factors
    1. Otitis Media extension (most common)
    2. Leukemia
    3. Mononucleosis
    4. Temporal BoneSarcoma
    5. Kawasaki Disease
  4. Etiologies
    1. Streptococcus Pneumoniae (22%)
    2. Streptococcus Pyogenes (16%)
    3. Staphylococcus aureus (7%)
    4. HaemophilusInfluenzae (4%)
    5. Pseudomonas aeruginosa (4%)
  5. Symptoms
    1. Unresolved Otitis Media
    2. Hearing Loss
    3. Fever spikes may exceed 104 F
    4. Otalgia
    5. Headache
    6. Pain at mastoid, occipital and parietal regions
  6. Signs
    1. Swelling and tenderness
      1. Postauricular
      2. Supraauricular
    2. Toxic appearance
    3. Inflamed and thickened TM (90% of cases)
    4. TM often perforated with Otorrhea
  7. Labs
    1. Complete Blood Count (CBC): Leukocytosis
  8. Radiology
    1. CT of Mastoid area (MRI if intracranial spread)
    2. Findings: Loss of mastoid air cells
  9. Management
    1. Admit for IV antibiotics
      1. Antibiotic course for 21 days
      2. Acute Mastoiditis
        1. Cefotaxime 50 to 180 mg/kg/day up to 1 g IV q4h
        2. Ceftriaxone 50 to 75 mg/kg/day up to 1 g IV q12h
      3. Chronic Mastoiditis (cover Pseudomonas)
        1. Ticarcillin-Clavulanate
    2. Surgical management
      1. Myringotomy drainage or
      2. Mastoidectomy (required in 50% of cases)
        1. Removes infected bone or mucosa
  10. Complications
    1. Temporal Lobe abscess
    2. Septic thrombosis of lateral sinus
  11. References
    1. Klein in Mandell (2000) Infectious Disease, p. 674
    2. Pfaff in Marx (2002) Rosen's Emergency Med., p. 932-3

Mastoiditis (C0024904)

Definition (MSHCZE) Zánět bradavkového výčnělku, obv. jako komplikace zánětu středního ucha (otitidy). Je nebezpečný dalším šířením infekce do mozku. Akutní m. vzniká při mezotitidě, někdy však se její příznaky mohou projevit až po odeznění nedostatečně léčeného zánětu. Jsou bolesti, celkové příznaky, výtok z ucha, zhoršení hypakuze, může být tinitus pulzujícího charakteru, lokálně bývá retroaurikulární prosáknutí, bolestivost až absces. Diagnózu doplňují i rtg změny. Terapie je operační – srov. (antro)mastoidektomie. Zvl. formami jsou tzv. okultní m. (může být u kojenců), nenápadná je rovněž mukózní m. (způsobená Staphylococcus mucosus). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) Inflammation of the honeycomb-like MASTOID BONE in the skull just behind the ear. It is usually a complication of OTITIS MEDIA.
Concepts Disease or Syndrome (T047)
MSH D008417
ICD9 383.9
ICD10 H70.9, H70.90
SnomedCT 194309002, 155230007, 52404001
English Mastoiditides, Unspecified mastoiditis, Mastoiditis NOS, Mastoiditis, unspecified, Mastoiditis, mastoiditis (diagnosis), mastoiditis, Unspecified mastoiditis, unspecified ear, Mastoiditis [Disease/Finding], Mastoiditis NOS (disorder), Mastoiditis (disorder), Mastoiditis, NOS
Dutch mastoïditis NAO, niet-gespecificeerde mastoïditis, Mastoïditis, niet gespecificeerd, mastoïditis, Mastoiditis
French Mastoïdite SAI, Mastoïdite non précisée, Mastoïdite
German Mastoiditis NNB, unspezifische Mastoiditis, Mastoiditis, nicht naeher bezeichnet, Mastoiditis
Italian Mastoidite non specificata, Mastoidite NAS, Mastoidite
Portuguese Mastoidite NE, Mastoidite
Spanish Mastoiditis no especificada, Mastoiditis NEOM, mastoiditis, SAI, mastoiditis, SAI (trastorno), mastoiditis (trastorno), mastoiditis, Mastoiditis
Japanese 乳様突起炎, 詳細不明の乳様突起炎, 乳様突起炎NOS, ニュウヨウトッキエンNOS, ニュウヨウトッキエン, ショウサイフメイノニュウヨウトッキエン
Swedish Mastoidit
Czech mastoiditida, Blíže neurčená mastoiditida, Mastoiditida, Mastoiditida NOS
Finnish Mastoidiitti
Russian MASTOIDIT, МАСТОИДИТ
Korean 상세불명의 꼭지염
Croatian MASTOIDITIS
Polish Zapalenie wyrostka sutkowatego
Hungarian nem meghatározott mastoiditis, mastoiditis, mastoiditis k.m.n.
Norwegian Mastoiditt
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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