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Mastoiditis: diagnosis
Last reviewed: 23.04.2024
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It is based on the characteristic general and local otoscopic signs, given palpation and percussion of the mastoid process, radiography of temporal bones in the Schuiller projection; in doubtful cases, if necessary differential diagnosis with lesion of the mastoid process of another etiology, CT or MRI is performed. The changes in the hemogram, the results of bacteriological examination of the discharge from the ear and the cavity of the subperiosteal abscess on the microflora and the sensitivity to antibiotics have a certain significance in the diagnosis.
In an anamnesis, the ear is diagnosed. Treatment, the frequency of exacerbation of otitis in recurrent or chronic course, the circumstances and causes of the development of the disease, the severity of the general disorder, the temperature response, the volume of previous emergency medical care.
Physical examination
Palpation, percussion of the mastoid process, X-ray of the temporal bones in the Schueller projection; if necessary, differential diagnosis with mastoiditis of another etiology - CT or MRI.
Laboratory research
Clinical analysis of blood, a smear of pus from the auditory canal and from the cavity of the mastoid process to the microflora and sensitivity to antibiotics.
Instrumental research
Otoscopy, a diagnostic paracentesis of the tympanic membrane with mastoiditis, developed against a background of acute otitis media.
Differential diagnostics
Carried out with external otitis, furuncle of the ear canal, suppurative parotid lymphadenitis, festering of congenital parotid cysts and fistulas; at apical mastoiditis - with other sources of phlegmon formation of the neck, with tuberculous sores.
Indications for consultation of other specialists
With the development of refractory intracranial complications, a consultation of a neurologist, a neurosurgeon, an ophthalmologist (to clarify the state of the ocular fundus), a toxicologist or an intensive care specialist is shown to clarify the nature and extent of detox therapy.
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