Diseases of The Middle Ear
In Mastoiditis tenderness is/are present at: [PGI Nov. 2010]
|D||Root of Zygoma|
It is a complication of actue otitis media in a child.
Pain and tenderness over the mastoid process are the initial indicators of mastoiditis.
Signs: - Mastoid tenderness: Tenderness is present over mastoid process, mastoid, tip, posterior border or root of zygome
- Mucopurulent / purulent pulsatile discharge (light house effect).
- Sagging of postero superior meatal wall.?
Perforation of pars tensa of tympanic membrane.
- Obliteration of retroauricular sulcus due to swelling over mastoiD. °
- Pinna is pushed forward and downward (antero inferior).
- Conductive type of hearing loss is always present. o
X-ray mastoids shows clouding of air cells.
10C is CT scan
Mgt - Antibiotics, myringotomy (If pus is under tension) and cortical mastoidectomy
Cortical Mastoidectomy lndications in ~ase of Mastoiditis
• Sub periosteal abscess
Sagging of postero superior meatal wall
Positive reservoir sign (meatus immediately fills with pus after it has been moped out).
No change in condition of patient or it worsens inspite ofadequate medical treatment for 48 hours.
Mastoiditis leading to complications eg facial nerve palsy, labyrinthitis or intracranial complications.