Introduction

Introduction to acute suppurative mastoiditis

There is a continuous mucosal phase between the middle ear mastoids, and there is an inflammatory reaction in the mastoid mucosa after the middle ear purulent infection. The initial stage is catarrhal, the mastoid area may have mild tenderness, the perforation of the tympanic membrane is pus, the mastoid The inflammatory response disappears. If the drainage is not smooth, or type III pneumococcal infection, the toxicity is very strong, destroying the bone, so that the mastoid small mucosa edema, hemorrhage, necrosis, it becomes acute suppurative mastoiditis, actually the follow-up of acute otitis media It should be called acute suppurative otitis media. Acute suppurative mastoiditis is an acute suppurative inflammation of the mucosa of the mastoid airway and its bone, which is often developed from acute suppurative otitis media. Mainly occurs in gasification mastoids, more common in children. The pathogenic bacteria of this disease are common with Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and the like.

basic knowledge

The proportion of sickness: 0.01%

Susceptible people: no special people

Mode of infection: non-infectious

Complications: osteomyelitis

Pathogen

Causes of acute suppurative mastoiditis

Cause:

Acute suppurative mastoiditis is an acute suppurative inflammation of the mucosa of the mastoid airway and its bone, which is often developed from acute suppurative otitis media. Mainly occurs in gasification mastoids, more common in children. The pathogenic bacteria of this disease are common with Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and the like.

Prevention

Acute suppurative mastoiditis prevention

1. Should improve the patient's physical health, strengthen nutrition, provide adequate protein and vitamin diet, strengthen the resistance to the emergency mountain material, keep the dressing clean until the wound heals.

2. After the occurrence of acute mastoiditis, it will collapse and expand outward within a certain period of time. It is necessary to go to the hospital for a simple mastoidectomy and remove the purulent material drainage in the ear and mastoid to prevent it. External expansion, the formation of post-abdominal abscess, inward expansion to form intracranial complications such as meningitis.

3. Prevention of acute mastoiditis occurs in the treatment of acute otitis media in a timely and timely manner.

4. Diversify the diet, pay attention to color, fragrance, taste, shape, and promote the appetite of the patient; cooking food should be steamed, boiled, stewed, eat foods that are difficult to digest, and ban alcohol.

Complication

Acute suppurative mastoiditis complications Complications osteomyelitis

After the infection, osteomyelitis is formed, and the inflammation lasts for a long time. The drainage is not easy and the intracranial infection is easy.

Symptom

Acute suppurative mastoid inflammation symptoms Common symptoms Post-ear mastoid edema bone destruction inflammatory tympanic membrane redness, red swelling after ear tympanic membrane tympanic congestion mastoid inflammation external auditory canal pain tinnitus eardrum perforation

In the otitis media, the symptoms and signs of the perforation of the tympanic membrane are aggravated, and most of them are caused by mastoid infection. The mastoid X-ray or CT scan shows that the mastoid area is cloudy or has bone destruction.

The degree of mastoid gasification is different, and the performance after inflammation is also different.

(1) gasification mastoid: small bone fragments are very thin, easy to necrosis and fusion to form a large cavity, called fusion mastoiditis, such as toxic hemolytic streptococcus and hemolytic influenza infection, often Mucosal vascular embolization, hemorrhagic necrosis, small room filled with bloody secretions, and the bone wall is not destroyed, called hemorrhagic mastoiditis.

(B) interstitial (barrier type) mastoid: less bone small room, thicker cortex and bone marrow structure, osteomyelitis after infection, inflammation for a long time, due to poor drainage and intracranial infection.

(3) Sclerosing type (stable type) mastoid: The small room is small and has an ivory-like structure. After infection, it is not easy to drain and is not easy to form bone destruction. It often causes mucosal tissue hyperplasia, tympanic membrane congestion, necrosis, and formation of gallbladder. Cholangiomas.

[clinical manifestations]

After otitis media, the pus increased, the back of the ear was red and swollen, the auricle shrugged forward, the pain in the wheat triangle behind the external ear canal, the tympanic membrane was congested and edema, and the tinnitus and deafness did not improve.

Examine

Examination of acute suppurative mastoiditis

Can check blood, pus bacterial culture plus drug sensitivity, papillary plain film and tibia thin layer CT help to confirm the diagnosis.

Diagnosis

Diagnosis and diagnosis of acute suppurative mastoiditis

diagnosis

Acute suppurative otitis media after perforation of the tympanic membrane, the clinical manifestations did not improve or worsened, should consider the disease. If the patient has earache, swelling around the ear, or other complications, even if there is no recent history of acute otitis media, the possibility of acute suppurative mastoiditis should be considered. Audiological examination and sacral imaging examination are helpful for diagnosis, and CT examination is of great significance.

Differential diagnosis

Acute mastoiditis should also be differentiated from external auditory canal fistula, soft tissue inflammatory disease behind the ear.