SymptomsComplaints
The symptoms of an inflammation of the middle ear (earache) do not subside, but persist or increase in intensity. Fever reoccurs and blood count changesChanges in laboratory values with an increase in the inflammation values of C-reactive protein (CRP), blood cell sedimentation rate (BSG increase) and white blood cells (leukocytosis) must be diagnosed. The ear findings are characterized as follows:
- The posterior upper wall of the auditory canal adjacent to the mastoid process sinks as a result of inflammation and accumulation of secretions and pus
- Pressure pain on the mastoid process (bone behind the ear that can be palpated from the outside);
- The X-ray image shows shadows indicating an inflammation with fluid (secretion);
- If there is an attack of the bone in the ventilated (pneumatized) bone space, this can be seen in a computed tomography image (CT) of the petrous bone (part of the temporal bone).
The breakthrough of the pus, which forms in the ventilated cells of the mastoid process, can occur in different ways:
- Subperiosteal abscessesA pasty swelling appears on the mastoid process behind the ear, so that the posterior auricle disappears.
Mastoiditis does not always have to be acute and cause severe symptoms.As a result of a long-lasting inflammation of the middle ear (otitis media), a chronic form of mastoiditis can also develop, which only shows very unspecific symptoms.
This is why it is called masked mastoiditis in this case. Due to its insidious course, it can remain unnoticed for months. Especially the main symptoms of mastoiditis such as fever or severe pain and redness of the mastoid can be completely absent.
The symptoms are usually unspecific, such as persistent headaches or fatigue. However, due to its proximity to brain tissue, chronic mastoiditis is also a potentially very dangerous disease. Special care is therefore required in cases of poor or non-healing otitis media.
