Mastoiditis Symptoms, Diagnosis and Treatment

Mastoiditis is a rare infection of the mastoid bone of the skull, which is located behind the ear. It is usually the result of untreated ear infections. When ear infections are left untreated for too long, the infection can spread to the mastoid bone. The cells inside this bone are filled with air and have a honeycomb-like structure, and the infection causes it to deteriorate.

Today the incidence of mastoiditis is very low, and life-threatening complications are even rarer. It is most prevalent in children. Before the invention of antibiotics, mastoiditis was actually one of the leading causes of death among children.

doctor examining toddler's ear for mastoiditis
ftwitty / E+ / Getty Images


Patients may experience a range of symptoms that might indicate mastoiditis. These include

  • Ear pain
  • Fluid discharge from the ear
  • Redness of the ear or behind the ear
  • Swelling behind the ear that may cause the ear to stick out
  • Fever
  • Headaches
  • Hearing loss
  • In the disease's late stages, abscesses in the neck called Bezold's abscesses

How can you tell when it's more than an ear infection? It is always best to talk to your healthcare provider.

Call your healthcare provider if you experience any of these symptoms, if your symptoms do not respond to treatment or if you have an ear infection that has not responded to treatment or is followed by new symptoms.

Diagnosis and Treatment

A healthcare provider should be able to identify mastoiditis based on symptoms and health history. Confirmation of this illness is obtained through several tests, including CT scans of the ear and head, and x-rays of the skull. Additionally, a culture of fluid drainage from the ear may also be taken to identify bacteria.

Treatment of mastoiditis depends on how far the infection has spread. In its early stages, the disease can easily be treated with a series of antibiotic injections and oral medication. Experts suggest that patients with acute mastoiditis should be admitted to the hospital and intravenous (IV) antibiotics should be started. If antibiotics alone are unsuccessful in treating mastoiditis, some of the bone may need to be removed, a procedure called a mastoidectomy.

Sometimes mastoiditis is difficult to treat because the medication cannot reach the bone, which requires long-term treatment. In some cases, ear tubes are implanted to prevent future ear infections and subsequent mastoiditis. A surgical procedure known as a myringotomy is also used to drain the middle ear to treat the ear infection.

Mastoiditis can also lead to labyrinthitis, which can cause the infection of cerebral spinal fluid, meningitis, and even death. Since the invention of antibiotics, however, labyrinthitis is very rare. Mastoiditis is much less dangerous today than it once was.

Potential Complications 

As previously mentioned, mastoiditis is quite uncommon and a lot less dangerous than it used to be. Still, there are several complications that can occur with the infection.  These may include:

  • Deterioration of the mastoid bone
  • Dizziness or vertigo
  • Facial paralysis
  • Hearing loss
  • Epidural abscess
  • Meningitis

Fortunately, mastoiditis can be cured, but it can be hard to treat and it can come back. You can prevent the infection from occurring by treating ear infections promptly and properly.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lustig, Lawrence, MD. Chronic otitis media, cholesteatoma, and mastoiditis in adults

    UptoDate. Aug 01, 2018.

  2. Palma S, Bovo R, Benatti A, et al. Mastoiditis in adults: a 19-year retrospective study. Eur Arch Otorhinolaryngol. 2014;271(5):925-31. doi:10.1007/s00405-013-2454-8

Additional Reading

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.