When Your Child Has Mastoiditis

Side view of ear showing infection in mastoid bone. SIde view of ear showing swollen area behind ear, pushing ear forward.

Your child has mastoiditis. This is an infection of the mastoid, the hard, bony area located right behind the ear. It's most often the result of an infection that started in the middle ear and spread to the bone.

What are the risk factors for mastoiditis?

Mastoiditis is more common in children than adults. Having any of the following may make getting it more likely:

  • An ear infection

  • Eustachian tube problems

  • A problem with the immune system

What are the signs and symptoms of mastoiditis?

  • Fever

  • Ear pain

  • Swelling over the mastoid bone causing the ear to turn forward

  • Redness, tenderness, or swelling behind the ear

  • Drainage from the ear canal or dizziness. This is uncommon.

  • Weakened facial muscles. This is also uncommon.

How is mastoiditis diagnosed?

Your child’s healthcare provider will ask about your child’s medical history. He or she will also do a physical exam. This helps find the best treatment. An imaging test, such as CT scan, may be done to help the healthcare provider make a diagnosis and view the mastoid area.

How is mastoiditis treated?

If mastoiditis is suspected, your child may be admitted into the hospital for evaluation and treatment. The hospital stay can last for 5 to 7 days or more. In the hospital, your child will be given intravenous (IV) antibiotics for the infection. Your child will see an otolaryngologist. This is a doctor who specializes in treating problems of the ears, nose, and throat (ENT). The ENT doctor may need to make a tiny incision in the eardrum to allow trapped fluid to drain out. This is called a myringotomy. It relieves pressure and the fluid can be tested. The test results help the ENT doctor determine which antibiotic to give your child. If these treatments don’t work, your child may need surgery to remove parts of the infected mastoid. This is called a mastoidectomy.

Long-term concerns

Once treated, the mastoid often causes no long-term problems. But if left untreated, mastoiditis can lead to a serious infection in and around the brain. To protect your child’s health, follow up with his or her regular healthcare provider.

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