Mastoiditis is an infection of the mastoid bone, which is the bone behind the ear. Mastoiditis is more common in children, but it can affect adults as well.
Mastoid bone is a bone that consists of air cavities and is soft in texture. The function of this air cavity, among others, is to protect the structures in the ear and regulate air pressure in the ear.

Mastoiditis can cause bothersome symptoms, especially for children. This condition needs to be treated immediately to relieve symptoms while preventing serious complications, such as the spread of infection to other parts of the body.
Causes of Mastoiditis
Mastoiditis is generally caused by an untreated middle ear infection ( otitis media ). This is because, when left untreated, the bacteria that infect the middle ear can spread to the inner ear, then to the mastoid bone, and cause damage.
Mastoiditis Risk Factors
As mentioned earlier, mastoiditis is more common in children, but adults can get it too. The following are some factors that can increase the risk of developing mastoiditis:
- 6 months to 2 years old
- Often exposed to cigarette smoke or dirty air
- Has a habit of drinking milk from a bottle while lying down
- Often in daycare, making it vulnerable to contracting infections
- Suffering from cleft lip, because this condition makes a person more susceptible to middle ear infections
Symptoms of Mastoiditis
The symptoms of mastoiditis are generally the same as those of other ear infections. These symptoms will usually appear after a severe ear infection or one that has recurred several times. Some of the symptoms of mastoiditis are:
- Discharge from the ear
- Ear pain
- Redness in the ear or behind the ear
- Swelling behind the ear that feels like it is filled with water
- The ears are pushed forward due to swelling behind the ears
- Headache
- Fever
- Hearing loss in the infected ear
When to see a doctor
Mastoiditis should be treated or even prevented as early as possible. Immediately check with an ear, nose and throat specialist ( ENT doctor ) if:
- Symptoms like the one above happen to you or your child
- Symptoms occur in infants under 6 months of age
- Blood or pus discharge from the ear
- Pain in the ear is unbearable
- The ear infection that you or your child is experiencing does not improve, even though it has been treated with medication from a doctor
You should also see a doctor if it is confirmed that you have mastoiditis and it doesn't get better despite being treated. This is very important to prevent complications.
Diagnosis of Mastoiditis
The doctor will begin the examination by asking about the symptoms the patient is experiencing. After that, the doctor will examine the inside of the patient's ear using an otoscope, which is a funnel-shaped instrument with a magnifying glass equipped with a light.
To confirm the diagnosis, the doctor may carry out supporting examinations in the form of:
- Blood test to count white blood cell levels
- Head scan with X-ray, CT scan, or MRI
- Culture of fluid coming from the patient's ear to detect the presence of bacteria
Based on the doctor's consideration, a lumbar puncture examination or taking fluid samples from the spine may be needed if the results of the examination above indicate mastoiditis. This examination aims to find out whether this infection has spread to the central nervous system.
Mastoiditis Treatment
Mastoiditis is a serious infection and can cause life-threatening complications. Therefore, this condition must be treated immediately with antibiotics .
Mastoiditis sufferers may require hospitalization so that antibiotics can be given by injection or infusion so they are more effective. Patients will usually also be given oral antibiotics after returning from the hospital.
If mastoiditis has not improved even though antibiotics have been given, the doctor may perform surgery, such as:
- Myringotomy, which is an operation to remove pus from the middle ear
- Mastoidectomy, which is surgery to remove the infected part of the mastoid bone
Mastoiditis complications
Mastoiditis can cause serious complications, especially if the mastoid bone is damaged due to late treatment or because the treatment is not effective. Some of these complications are:
- vertigo
- Paralysis of the facial nerve
- Hearing loss or deafness
- Inflammation of the lining of the brain or meningitis
- Abscess of the brain or spinal cord
- Sepsis
Mastoiditis Prevention
Considering that mastoiditis occurs as a result of untreated otitis media, the best way to reduce the risk of developing mastoiditis is to prevent otitis media or other ear infections.
The following are some steps parents can take to prevent mastoiditis in children:
- Immunize children according to the recommended schedule.
- As much as possible do not let the child drink milk from the bottle while lying down.
- Protect children from exposure to cigarette smoke and air pollution.
- Give exclusive breastfeeding to babies.
- Don't take your child too often to places that are crowded and have a risk of transmitting infection, such as malls and daycare centers.
In addition, immediately consult a doctor if the child has signs of an infection in the ear, for example, the ear hurts or discharge comes from the ear. Early detection and treatment of ear infections can prevent mastoiditis.
For adults, steps to prevent mastoiditis can be done by stopping smoking and controlling allergies if any. Adults who have frequently experienced otitis media are also advised to consult a doctor regarding treatment to prevent recurrence of otitis media.