1. Presented by:
Ms. Elizabeth M.Sc (N)
Asst. Professor,
Dept of MSN
NNC, GNSU.

2. The mastoid process is the
portion of the temporal bone
of the skull that is behind the
ear which contains open, air-
containing spaces

3. DEFINITION
Mastoiditis is inflammation and infection of the mast cells in the
mastoid bone.

4. CLASSIFICATION
1. Acute mastoiditis
2. Chronic mastoiditis: It is most commonly associated with CSOM

5. Aetiology & Risk Factors
1. Infection of the middle ear.
2. Injury of the mastoid bones and cells.
3. Cholesteatoma.
4. Upper respiratory infection.
5. Causative organisms - Streptococcus pneumonia,
streptococcus pyogenes, staphylococcus aureus, heamophilus
influenzae and morexalla catarrhalis

6. Clinical Features
1. Otalgia.
2. Swelling on the mastoid bone.
3. Perforation of the ear drum.
4. Loss of hearing.
5. Severe pain at eating time.
6. Increased cranial pressure.
7. Painless discharge from the affected ear.
8. Otorrhoea
9. Nausea, vomiting.

7. PATHOPHYSIOLOGY
Due to infection
of middle ear
Infection reaches at
mastoid air cells
Mastoiditis

8. DIAGNOSIS
1. History collection.
2. Physical examination.
3. Mastoid bone x ray.
4. CT scan.
5. Lab: CBC, DLC, Blood culture
6. Audiography.
7. C & S - Tympanocentesis

9. MEDICAL MANAGEMENT
1. Antibiotic and steroid eardrop for infection and inflammation, e.g.
Ciplox-D.
2. Ear-irrigation: For removing purulent discharge.
3. Analgesics drugs: Aspirin, Nimuslide

10. SURGICAL MANAGEMENT
1. Mastoidectomy: It is a surgical procedure that removes diseases
mastoid air cells.
Simple mastoidectomy – surgeon opens the mastoid bone, removes the infected air cells,
and drains the middle ear
Radical mastoidectomy –surgeon remove the eardrum and middle ear structures. Skin graft
is placed in middle ear after the procedure
Modified radical mastoidectomy – this is less severe form of radical mastoidectomy. Not all
middle ear bones are removed and the ear drum is rebuilt.
Mastoidectomy also done to place cochlear implant

11. 2. Myringotomy: It is a surgical procedure in which a tiny incision is
created in the eardrum relieves pressure caused by excessive buildup
of fluid or pus.
3. Tympanoplasty: also called eardrum repair. It is the surgical
reconstruction of the perforated eardrum or the small bones of the
middle ear.

12. Post - op Care
• Follow up date will fix for the removal of stitches and bandage
• Cover the operative site while bathing (pertroleum jelly covered
cotton ball)
• Avoid streneous activity
• Avoid air travel
• Avoid putting pressure on ear

13. NURSING MANAGEMENT
• Assess pain for location, intensity etc.
• Administer analgesics as prescribed to relieve pain.
• Administer antibiotics as ordered.
• Administer antipyretics as prescribed.
• Provide plenty of fluids.
• Use coolwater sponging to reduce bodytemperature
• Encourage patient and family to use signs of non verbal
communication such facial expression, pointing, body movement.

14. NURSING DIAGNOSIS
• High risk for infection relate to tissue destruction.
• Pain relate to physical factors.
• Altered auditory sensory perception related to partial/total
perforation of tympanic membrane.
• Impaired verbal communication related to hearing deficit.
• High risk for trauma realted to balance difficulty.

15. COMPLICATIONS
• Facial paralysis
• Nausea, vomiting,
• Vertigo
• Hearing loss
• Brain abscess or meningitis
• Vision changes or headaches (blood clots in the brain)