Mastoiditis In Children

What is mastoiditis in children?

Mastoiditis is an infection in the mastoid bone of your child's skull. The mastoid bone is located behind your child's ear. Mastoiditis is most common in children younger than 4 who have a history of ear infections. Mastoiditis is often caused by an ear infection that spreads. Your child's ear canal swells and traps fluid inside his ear. Trapped fluid causes bacteria to grow and spread to his mastoid bone.

What are the signs and symptoms of mastoiditis?

Signs and symptoms of mastoiditis in your child may appear like an ear infection:

• Pain, redness, swelling, or tenderness behind or inside his ear
  
  
• Fluid may drain from his ear
  
  
• His ear may stick out from his head, or he may tug his ear
  
  
• Headache or fever
  
  
• Tiredness, anger, or fussiness
  
  
• Loss of appetite or vomiting (small children)
  
  
• Hearing loss or facial numbness

How is mastoiditis diagnosed?

Your child's caregiver will examine your child's ear, and ask about his signs and symptoms. Your child may also need the following:

• Blood tests: Blood tests check for infection. The blood may be taken from your child's arm, hand, finger, foot, heel, or through an IV.
  
  
• Fluid cultures: Your child's caregiver may test any fluid that drains from your child's ear. Fluid cultures may show what kind of bacteria is causing the infection.
  
  
• CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your child's skull and brain. The CT will show how serious your child's infection is. It will also show if he has bone damage or an abscess in his skull or brain. Your child may be given dye, also called contrast, before the test. This dye helps improve the pictures. Tell your child's caregiver if your child is allergic to iodine or seafood. He may also be allergic to the dye.
  
  
• MRI: An MRI uses a powerful magnet and radio waves to take pictures of the inside of your child's body. An MRI will show if your child's infection has spread. It may also help show if there are any other problems, such as bone loss. Your child will need to lie still during his test. Never enter the MRI room with any metal objects. This can cause serious injury.

How is mastoiditis treated?

Your child's condition may improve with prompt treatment and close follow up. Your child may also need the following:

• Medicine:
  
  
  • Antibiotics: This medicine will help fight or prevent an infection caused by bacteria. Make sure your child takes his antibiotics until they are gone, even if he feels better sooner.
    
    
  • Pain medicine: Your child may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you give your child his medicine.
    
    
  • Ibuprofen or acetaminophen: These medicines are available without a prescription. They may decrease your child's pain and fever. Ask how much medicine your child needs and how often to give it.
    
    
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin when he is sick. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  
  
• Surgery: Ask your child's caregiver about these and other procedures your child may need:
  
  
  • Myringotomy and ear vent tubes: Myringotomy is surgery to help release pressure in your child's ear by puncturing a small hole in his eardrum. He may also need middle-ear ventilation tubes (MEVT) placed into his ear to relieve pressure from the fluid.
    
    
  • Mastoidectomy: Mastoidectomy is surgery to remove any infected part of your child's mastoid bone. Your child may need this surgery if his condition is severe, other treatments are not working, or he has a consistent fever. He may also need mastoidectomy if he has an abscess inside his mastoid bone. An abscess is an area that is swollen with fluid.
    
    
  • Abscess drainage: An abscess in your child's ear, mastoid bone, or other areas in his skull may need to be drained. This may happen if your child is not responsive, or if he has severe swelling on his neck or behind his ear.

What are the risks of mastoiditis?

Your child's mastoiditis infection may spread to other bones in his head, face, and neck. The infection may cause bone loss if it is not treated right away. Your child's symptoms may come back, even after treatment. Mastoiditis may cause permanent hearing loss. Mastoiditis may also result in a brain infection, seizures, facial nerve damage, brain swelling, or meningitis. Meningitis is swelling of the tissue (meninges) that surrounds your child's brain and spine. It is caused by an infection, such as mastoiditis. Mastoiditis may also cause blood clots in your child's sinuses. Your child may need surgery if his mastoiditis is severe. Mastoiditis can become life-threatening if it is not treated.

When should I follow up with my child's caregiver?

Follow up with your child's caregiver or ear, nose, and throat specialist as directed. Ask if your child will need certain hearing tests. These tests will help find any permanent hearing problems after he has healed from mastoiditis. Write down any questions about your child's care so you remember to ask them during your visits.

How can mastoiditis be prevented?

Ask your child's caregiver about these and other ways to prevent ear infections that may lead to mastoiditis:

• Keep your child away from cigarette smoke, or areas that smell like cigarette smoke.
  
  
• Keep your child away from other children who are sick. Make other childcare arrangements if you need to.
  
  
• Continue to breastfeed your child if you already are. This may reduce the risk of ear infections and mastoiditis.
  
  
• Vaccines may help prevent ear infections and mastoiditis. Ask your child's caregiver which vaccines are right for your child.

When should I contact my child's caregiver?

Contact your child's caregiver if:

• You think your child's medicine is not working.
  
  
• You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately if:

• Your child's symptoms, such as pain, redness, swelling, ear drainage, or hearing loss get worse.
  
  
• Your child's fever gets worse, or does not go away with treatment.
  
  
• Your child has a headache that does not go away with treatment.
  
  
• Your child has weakness in his face.
  
  
• Your child has a mass behind his ear that is red and swollen.
  
  
• Your child has trouble hearing.
  
  
• Your child has a seizure or loses consciousness.
  
  
• Your child has a headache, fever, and a stiff neck.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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