INTRODUCTION :
The mastoid process is the portion of the temporal bone of the skull that is behind the ear which contains open, air-containing spaces.
DEFINITION :
It is an inflammation of mastoid process behind the ear and of the air space connecting it to the cavity of the middle ear.
ETIOLOGY :
1. Infection of the middle ear.
2.Injury of the mastoid bone and cells.
3.Upper respiratory infection. – Rhinitis. – Sinusitis.
4. Related to zygoma fractures.
5. Cholesteatoma
CLINICAL MANIFESTATION :
✓ Otalgia ( ear pain.)
✓ Swelling of the mastoid bone.
✓Loss of hearing.
✓Sever pain at eating time.
✓Painless discharge from the effected ear.
✓Nausea, vomiting.
✓Increased cranial pressure.
✓Otorrhoea ( purulent discharge.) may be odourless or foul smelling.
✓Perforation of the ear drum.
PATHPHYSIOLOGY
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Due to etiological factor that is Infection of the middle ear
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Acute otitis media
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Infection reaches at mastoid air cells
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Inflammation of the mastoid process.
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MASTOIDITIS
DIAGNOSTIC EVALUATION :
1. History collection.
2. Physical examination.
3. Mastoid bone x ray.
4. CT scan.
5. Lab: CBC, DLC, Blood culture, tympanocentesis,FNAC-Fine Needle Aspiration Cystology (Biospy if needed)
6. Audiography.
MEDICAL MANAGEMENT
1. Antibiotic and steroid ear drop for infection and inflammation. E.g.,Ciplox-D
2.Ear- Irrigation – for purulent drainage.
3.Analgesic drugs, e.g., Aspirin, Nimuslide.
SURGICAL MANAGEMENT :
Mastoidectomy:
It is a surgical procedure that removes diseases mastoid air cells.
Myringotomy:
It is a surgical procedure in which a tiny incision is created in the eardrum relieves pressure caused by excessive build up of fluid or pus.
Tympanoplasty:
It is also called eardrum repair. It is the surgical reconstruction of the perforated eardrum or the small bones of the middle ear.
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 cool water sponging to reduce body temperature,
•Encourage patient and family to use signs of non verbal communication such facial expression, pointing, body movement.
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 related to balance difficulty.
TAMILNADU NURSING 