One of the foremost vital structures in your inner ear is the mastoid bone. In spite of the fact that it’s called a bone, the mastoid doesn’t have the commonplace structure associated with other bones within the human body. It’s made to air sacs and resembles a sponge, instead of being solid and unbending like most bones.
It is an infection of the mastoid air cells caused by untreated or inadequate treated otitis media. Infection can be acute or chronic.
The most common cause of mastoiditis is Middle ear infection if it is left untreated or inadequately treated otitis media. This can cause the mastoid bone to begin to disintegrate.
Mastoiditis Symptoms or Clinical Manifestation:-
- Mastoid tenderness ( Swelling behind the ear ).
- Pain behind the ear.
- Redness behind the ear.
- Purulent ear discharge.
- Fever, malaise, anorexia.
- Hearing loss.
- Tympanic perforation.
- Otoscopic Examination:- A red thick immobile eardrum with or without perforation.
- C.T. Scan ( Fluid in mastoid air cells ).
- Culture of ear drainage.
- Physical examination.
Mastoiditis Surgical Management:-
- Mastoidectomy:- It is the surgical removal of all the impacted tissues so infection does not spread to other structures.
- Tympanoplasty:- It is the reconstruction of eardrum and ossicles to improve the hearing.
- Tympanoplasty 1st (Myringoplasty):- A graft ( muscle fascia, skin, or venous tissue ) is placed over a perforation in the tympanic membrane and other middle ear structures are normal.
- Tympanoplasty 2nd (Ossiculoplasty):- The matter which has become displaced/disconnected from the tympanic membrane is grafted to reconnect the structures. (The patient cartilage, or bone, cutover ossicles, stainless steel, wires are used to repair or replace ossicles ).
Mastoiditis Surgical Approach of the Ear:-
- Trans canal Approach.
- Endaural approach.
- Post auricular approach ( It is used for the more extensive repair of the middle ear and inner ear structure).
Mastoiditis Surgery Pre-operative Care:-
- Give systemic antibiotics to reduce infection.
- Before surgery irrigates the ear with a solution of equal parts of vinegar and sterile water to maintain normal pH.
- Avoid contact with people with upper respiratory tract surgery.
- Assure the patient that hearing loss after surgery is normal.
- Teach deep breathing exercises after surgery.
Mastoiditis Surgery Post-operative Care:-
- An antiseptic soft gauze packed in the ear canal.
- If the skin incision is used a dressing placed over it.
- Keep dressing dry and clear using sterile training.
- Regular observe incision sight for signs of incision or hemorrhage.
- Keep the patient flat with the head turned to the side and the operative side of ear facing up for at least 12 hours after surgery.
- Avoid physical activity.
- Give prescribed antibiotics.