Does mastoiditis go away on its own

Mastoiditis is a serious bacterial infection that affects the mastoid bone behind the ear. It's usually more common in children, although adults can also sometimes be affected.

Symptoms of mastoiditis 

The mastoid bone has a honeycomb-like structure that contains air spaces called mastoid cells. The mastoid cells help maintain the air space in the middle ear.

Mastoiditis can develop if the mastoid cells become infected or inflamed. This is often as a result of a persistent middle ear infection (otitis media). This can cause the porous bone to break down.

Symptoms of mastoiditis typically include:

• redness, tenderness and pain behind the ear
• swelling behind the ear that can cause it to stick out
• discharge from the ear
• a high temperature, irritability and tiredness
• headache
• hearing loss in the affected ear

When to see your GP 

You should see your GP if you or your child has:

•  any symptoms of mastoiditis
•  an ear infection that doesn't clear up with treatment or is followed by new symptoms
•  been diagnosed with mastoiditis and treatment hasn't cleared it up

Causes of mastoiditis

Mastoiditis usually occurs following an untreated middle ear infection. Bacteria from the middle ear can spread to the inner ear, infecting the mastoid cells of the mastoid bone.

cholesteatoma can also cause mastoiditis. This is an abnormal collection of skin cells inside the ear. This may prevent the ear draining properly, leading to infection.

How mastoiditis is diagnosed 

Your GP will examine the inside of the ear with an otoscope (a device with a light and magnifying glass). This is to check for signs of infection or cholesteatoma.

Most ear infections are middle ear infections. If your GP thinks you have mastoiditis as a complication of a middle ear infection, they may refer you to an ear, nose and throat (ENT) specialist.

How mastoiditis is treated 

Mastoiditis is a serious infection and should be treated quickly. It's treated with antibiotics.

Depending on how severe the infection, you may need to go to hospital so that you can be given antibiotics directly into a vein through a drip.

In some cases, surgery may be needed to drain your middle ear (a myringotomy) or to remove part of the mastoid bone (mastoidectomy).

Outlook 

If you've had surgery for mastoiditis, you may need to take time off work. Your doctor will advise you about this.

Take care not to get the affected ear wet. You should be able to wash your hair after about a week, providing you don't get water inside your ear.

You should be able to go swimming around four to six weeks after the operation, depending on how well your ear has healed. Your doctor should be able to advise you at your follow-up appointment.

With early antibiotic treatment, most people with mastoiditis recover quickly and have no complications. However, treatment isn't always easy and the infection may come back.

If the mastoid bone is severely infected and infected bone isn't removed, it can cause hearing loss and life-threatening health complications such as a blood clot, meningitis, or a brain abscess.

More useful links

• How to use your health services

The information on this page has been adapted from original content from the NHS website.

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What is mastoiditis?

One of the most important structures in your inner ear is the mastoid bone. Although it’s called a bone, the mastoid doesn’t have the typical structure associated with other bones in the human body. It’s made of air sacs and resembles a sponge, rather than being solid and rigid like most bones.

The mastoid must receive air from other parts of the ear, including the eustachian tube, to function properly. Your eustachian tube connects your middle ear to the back of your throat. If an infection develops in your middle ear and blocks your eustachian tube, it may subsequently lead to an infection in the mastoid bone. This serious infection is known as mastoid bone infection of the skull, or mastoiditis.

The most common cause of mastoiditis is a middle ear infection that has been left untreated. It can spread to your inner ear, invading the sacs of the mastoid bone, without treatment. This can cause the mastoid bone to begin to disintegrate.

Although the condition is most common in children, it can also occur in adults.

The symptoms of mastoiditis are similar to those of an ear infection. They include:

• drainage from the affected ear
• ear pain
• fever
• headache
• hearing loss in the affected ear
• redness, swelling, and tenderness behind the affected ear

In some cases, mastoiditis may result in the development of a brain abscess or other complications involving your skull. The symptoms of these conditions include severe headaches and swelling behind your eyes. This swelling is known as papilledema.

If you have symptoms of an ear infection, your doctor will examine your ears and head to determine if the infection has spread to your mastoid bone.

The mastoid bone is located in your inner ear and may not be visible due to the infection. Your doctor may perform other tests to confirm the diagnosis. These include:

• a white blood cell count to confirm the presence of an infection
• a CT scan of your ear and head
• an MRI scan of your ear and head
• an X-ray of your skull

If the tests confirm a diagnosis of mastoiditis, your doctor may also perform a lumbar puncture, or spinal tap. This test will allow your doctor to determine if the infection is present in your spinal column.

Mastoiditis is a potentially life-threatening condition. Initial treatment for a severe infection may include hospitalization. You will receive antibiotic medication through a vein in your arm, or intravenously, while at the hospital. You will need to take oral antibiotics at home for several days after leaving the hospital.

If the infection doesn’t clear up after treatment with antibiotics, surgery may be necessary. Surgery may involve removing part of your mastoid bone to drain the infection. Doctors may also need to drain your middle ear of infected fluid to successfully treat the infection.

Treatment of mastoiditis can be difficult because the mastoid bone is located deep inside your ear. Serious health problems may result if treatment isn’t effective or if the infection isn’t treated before damaging the mastoid. These health problems include:

• vertigo, or dizziness
• facial paralysis
• hearing loss
• meningitis, a bacterial infection of the membranes covering your brain and spinal cord
• epidural abscess, a collection of pus on the outside of your brain and spinal cord
• sepsis, a spreading of the infection throughout your body

You can prevent mastoiditis by effectively treating all ear infections. Seek prompt medical attention and follow your doctor’s advice if you develop an ear infection. This may include taking oral antibiotics for 7 to 10 days.

Early intervention is necessary to prevent permanent damage if mastoiditis develops. Even if treatment is successful, the infection may return. Doctors will need to monitor those who develop mastoiditis to ensure that the infection doesn’t return or spread.