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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 years 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

  • Fatigue or fussiness

  • Vomiting or loss of appetite (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 are done to check for infection.

  • A fluid culture is a test of fluid that drains from your child's ear. Fluid cultures may show the kind of bacteria that is causing the infection.

  • A CT scan or an MRI is 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. An MRI may show if there are any other problems, such as bone loss. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if your child has ever had an allergic reaction to contrast dye. He should not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if your child has any metal in or on his body.

How is mastoiditis treated?

  • Medicine:

    • Antibiotics help treat or prevent a bacterial infection.

    • Prescription pain medicine may be given. Ask your child's caregiver how to give this medicine safely.

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's doctor.

    • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much your child should take and how often he should take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

    • Do not give aspirin to children younger than 18 years. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.

  • Surgery:

    • A 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.

    • A 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.

    • Drainage of an abscess in your child's ear, mastoid bone, or other areas in his skull may be needed. Abscess drainage may be done if your child is not responsive, or if he has severe swelling on his neck or behind his ear.

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 your questions so you remember to ask them during your visits.

How can I help 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?

  • 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 or call 911?

  • 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. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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