1. Etiology of middle ear mastoiditis
1 Acute Mastitis
More common in children. Strong virulence of pathogenic bacteria, low resistance of patients, untimely treatment of otitis media or poor discharge of middle ear pus are all the causes of the disease. The infection spread to the mastoid process, causing air cavity empyema and bone fusion necrosis; The clinical symptoms are more serious than acute suppurative otitis media, or the symptoms are not relieved after the discharge of ear purulent secretions, and the mastoid part behind the ear is red, swollen and tender. X-ray mastoid film can help diagnosis. In addition to active use of antibiotics, myringotomy or mastoidectomy should be performed in some cases to avoid serious complications.
2. Chronic mastoiditis
Complicated with chronic suppurative otitis media, simple type leads to mastoid air cavity development disorder and mastoid sclerosis Dangerous type can cause mastoid bone destruction, in which bone selective type can cause necrosis of tympanic sinus and mastoid bone, granulation tissue formation, enlargement of tympanic sinus, and mastoid bone destruction can be seen in mastoid film. Cholesteatoma-type cholesteatoma spreads to mastoid through the superior tympanum and sinus, and a typical cavity with clear edge can be seen on X-ray film. Mastoid lesions erode the neighboring bones, which can cause the destruction of mastoid cortex, posterior wall of bony ear canal, semicircular canal, facial nerve canal, meningeal plate and sigmoid sinus bone plate. Acute attack can cause serious extracranial and intracranial complications. Therefore, once the destruction of mastoid bone is diagnosed, mastoid surgery should be performed immediately to clarify the focus and prevent complications.
3, occult mastoiditis
It mainly occurs in children and is characterized by progressive inflammatory changes hidden behind the intact tympanic membrane. Most pathogens are Haemophilus influenzae, and most of them are due to acute otitis media, purulent lesions invading bones, which often lead to complications due to missed diagnosis, so we should be vigilant.
The above are the related introductions about the causes of three kinds of mastoiditis. I believe our mastoiditis patients have understood. Because mastoiditis is difficult to treat, we can't be careless. The key is to have a positive attitude towards mastoiditis and keep a good mood at the same time. The prevention of mastoiditis in life is also essential.
2. Clinical manifestations of otitis media and mastoiditis
(1) The main symptoms of acute suppurative otitis media, such as fever, earache, hearing loss and purulent secretion in the ear, should disappear quickly after perforation of tympanic membrane and discharge of purulent secretion in the middle ear. However, if the previously subsided symptoms reappear or worsen after 1 ~ 2 days of perforation, and the child has severe gastrointestinal symptoms such as vomiting and diarrhea, the possibility of acute mastoiditis should be considered.
(2) The mastoid skin is swollen, flushed and tender.
(3) The posterior superior wall of the external auditory canal is swollen and collapsed; The perforation of tympanic membrane is small, there is pus pulsation at the perforation, and the amount of pus is large; Sometimes pus penetrates the outer wall of mastoid and forms abscess under periosteum.
(4) The X-ray film of mastoid shows that the air cavity is vague, and the atrial septum is unclear after the abscess cavity is formed, and it is merged into a transparent area, which is like a cloud.
(5) Leukocytes increased and polymorphonuclear cells increased.
Patients with otitis media should be actively treated to prevent otitis media mastoiditis.