Mastoditis with Sub-Periosteal Abscess

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It is due to infection of the mastoid air cells in the middle ear, a complication of chronic suppurative  otitis media. It presents as a fluctuant painful swelling on the post auricular area. The overlying skin  is also inflamed. 

Non-pharmacological Treatment 

  • Aspirate  the  swelling  before  incision  and  drainage,  and  then  refer  for  mastoidectomy  at  a  zonal/national hospital 

Pharmacological Treatment: 

C: ciprofloxacin ear drops, 3drops, 12hourly for 14days 

AND 

A:  ciprofloxacin  (PO)  500mg  12hourly  for  10days;  Children  10–20mg/kg  12hourly  for 10days 

Investigations 

  • Culture & sensitivity
  • CT SCAN-Temporal Bone

Surgical management 

  • Incision and drainage
  • Mastoidectomy/Drainage mastoidectomy
  • Tympano-mastoidectomy
  • Ossiculoplasty

Note:  Treatment shorter than 10days will result into treatment failure