In people in modern society Ear diseases are detected very often and are very diverse.

Read in this article

Causes

The main reasons for the development of ear diseases may be infectious diseases.

Main infectious symptoms

• Hemolytic streptococcus (causes erysipelas outer ear). Pseudomonas aeruginosa (most often the cause of purulent perichondritis).
• Staphylococcus (furuncle of the external ear, acute and chronic tubootitis)
• Streptococcus (inflammation eustachian tube, otitis media)
• Pneumococcus (causes otitis media)
• Molds (cause otomycosis)
• Influenza virus (otitis media)
• Mycobacterium tuberculosis (ear tuberculosis).
• Treponema pallidum (ear syphilis)

Because of these infections, complications of inflammatory processes in other organs can begin - these include lesions of the sinuses (acute and chronic sinusitis, sinusitis). This happens after a person has had a sore throat, scarlet fever, influenza, etc.

The development of infection is influenced by factors such as minor ear injuries, decreased local and general immunity, if a person does not clean their ears, and allergies. It is worth remembering that infectious lesions, in addition to inflammatory processes, can cause complications in the future, including sensorineural hearing loss.Ear diseases can also be caused by increased gland function. ear canal, as a result of which, due to improper hygiene, a sulfur plug is formed.Also harmful to the ear medications, namely antibiotics of the aminoglycosin group.

Physiological symptoms of ear disease development

• Bruise, blow, bite
• High and low temperatures
• Chemical acids and alkalis
• Acoustic
• Ultrasound
• Vibration vibrations
• Barotrauma
• Extra items

Symptoms

Pain most often appears with inflammatory diseases of the ear apparatus. The pain can be severe with a boil, or also mild, for example with eustachitis). The pain may radiate to eyeballs, lower jaw. It can also begin when chewing or swallowing. Pain in the head on the affected side is possible. Also, often with inflammation, the ears begin to turn red, the ear swells and profuse pus begins.

A few more symptoms of ear inflammation:

• Increased body temperature
• Chills
• Man doesn't eat
• Doesn't sleep well
• Allergy, itching, burning
• Feeling like there is water in your ears
• Purulent discharge from the ear
• Hearing loss
• Noise in ears
• Autophony
• Hearing loss
• Lack of ability to perceive sounds.
• Dizziness
• Nausea and vomiting

Treatment

When you come to see a doctor, he will pay attention to redness, swelling, look into the ear canal, and pay attention to swelling and karosti. With palpation it is possible to evaluate more significantly pain symptom. You need to find out which part of the ear hurts, where the pain goes, how painful it is when you press on the ear.

How to understand what is happening to the ear:

• External inspection
• Ear palpation
• Otoscopy
• Patency of the auditory tubes
• Toynbee method
• Valsalva method
• Politzer method
• Catheterization

If you notice changes in your body and notice that symptoms related to the hearing aid have appeared, then you need to contact an expert to prevent complications. After all, a person can lose his hearing.

Any extras?

If you can add to the article or have come across a good definition of ear disease and mastoid process leave a comment on this page. We will definitely add to the dictionary. We are confident that it will help hundreds of current and future addiction psychiatrists.

Diseases of the ear and mastoid process

Otitis externa

This disease is an inflammation of the external auditory canal. Otitis externa occurs as a result of infection of cracks and abrasions of the skin when scratching and picking the ear, as well as from burns, injuries and purulent inflammation of the middle ear.

Main clinical symptoms

There is itching, pain in the ear and purulent discharge from it with unpleasant smell. Otoscopy reveals swelling of the walls of the external auditory canal, desquamation of the epidermis and the presence of purulent discharge.

The eardrum is also covered with desquamated epidermis.

The pus is removed with a cotton swab, and then the external auditory canal is washed with a solution of furatsilin at a dilution of 1: 5000. If there are ulcers, they are cauterized with a 1% silver solution. In addition, the skin of the external auditory canal is lubricated with synthomycin emulsion.

Furuncle of the external auditory canal

It develops when various manipulations Hair or sebaceous follicles in the external auditory canal become infected.

Main clinical symptoms

Pain occurs in the ear, as well as when pressing on the tragus or pulling on the auricle. In addition, the external auditory canal narrows due to the maturing boil, and regional lymph nodes become enlarged and painful.

In the first days of the disease, use antibacterial drugs. Turunda soaked in alcohol is injected locally into the external auditory canal; various emulsions are used while the process subsides. In addition, antipyretic and painkillers are prescribed.

If the boil is ripe and pain syndrome intensified, they resort to surgical opening.

Sulfur plug

It occurs as a result of increased function of the glands located in the membranous-cartilaginous part of the external auditory canal. Sulfur plug is a conglomerate of dried secretion from the skin of the ear canal.

IN normal conditions wax, drying, is removed from the ear canal as a result of displacement of the anterior wall caused by movements of the maxillary joint during speaking and chewing.

If no measures are taken, the epidermal plug dries out, becomes dense and firmly fixed to the walls.

Main clinical symptoms

Hearing loss, tinnitus, and autophony (increased perception of one's own voice in one ear) are observed. These symptoms appear when the ear canal is completely blocked by sulfur masses. In these cases, dizziness may also occur, headache, nausea and cardiac dysfunction.

The main method of treatment is rinsing the external auditory canal with warm water (in the absence of perforation eardrum due to previous illnesses). After this, the eardrum is inspected, and the remaining water is removed with a dry cotton swab.

Otitis externa with mycoses

Otomycosis – fungal disease, caused by the development of various molds, as well as yeast-like fungi of the genus Candida, on the walls of the external auditory canal.

Contributing factors for otomycosis can be: general or local allergies, as well as metabolic disorders or dysfunction of the sulfur glands. As the fungi develop, they form a plexus of mycelium, which causes inflammation of the skin.

Main clinical symptoms

There is constant itching in the ear canal, increased sensitivity ear canal, congestion and noise in the ear. In addition, headaches on the affected side and mild pain occur. There is also a characteristic discharge from the external auditory canal, reminiscent of wet blotting paper, the color of which depends on the pathogen - from greenish to gray-black. The process extends to the auricle and behind the ear area.

Otomycoses caused by yeast-like fungi resemble weeping eczema.

Diagnostics

The final diagnosis is made based on examination and the results of microscopic examination of the contents of the external auditory canal.

The main treatment is local antifungal therapy depending on the type of fungus. In addition, they are appointed antifungal drugs, and after preliminary cleaning of the external auditory canal - ointment.

Nonsuppurative otitis media

Non-purulent (catarrhal) otitis develops when the inflammatory process moves to the mucous membrane auditory tube And tympanic cavity. Acute inflammation of the middle ear is closely related to the pathology of the auditory tube. Pathogens can be streptococci, staphylococci, pneumococci, etc.

Main clinical symptoms

Congestion in one or both ears, decreased hearing, a feeling of heaviness in the head, as well as tinnitus and autophony are observed.

The degree of hearing loss may vary. During otoscopy, the color of the eardrum may have different shades.

The nose, nasopharynx are treated and the patency of the auditory tube is restored. Vasoconstrictors and antiallergic drugs are prescribed.

In addition, the ears are blown using Politur through a catheter and pneumomassage of the eardrums is performed.

Acute purulent otitis media

Acute purulent otitis media is a fairly common disease. It can be mild or severe. Typically, acute purulent otitis is not limited to one tympanic cavity, but inflammatory process the remaining parts of the middle ear are also involved. The immediate cause is infection, and predisposing factors may be hypothermia and a decrease in the overall reactivity of the body.

Penetration of infection into the middle ear occurs most often through the auditory tube.

Main clinical symptoms

In the typical course of acute purulent otitis media there are 3 stages.

Stage I is characterized by the emergence and development of an inflammatory process in the middle ear, the formation of infiltration and exudate, hyperemia of the eardrum, stretching of its exudate, as well as decreased hearing and general symptoms in the form of a temperature reaction, decreased appetite, deterioration of well-being, severe leukocytosis and an increase in ESR.

At stage II the eardrum is perforated and suppuration occurs from the ear. This leads to an increase in the amount of exudate in the tympanic cavity, its pressure increases, which causes thinning of the eardrum and its perforation. After this, the pain in the ear decreases, the temperature drops, and general state the patient is improving.

At stage III the inflammatory process subsides with restoration functional state middle ear.

At favorable course recovery occurs, and the perforation of the eardrum is closed by a scar. However, adhesions and adhesions may occur between the eardrum and the walls of the tympanic cavity, and persistent dry perforation may develop.

At chronic course suppuration from the ear, mastoiditis, petrositis, labyrinthitis and paresis are observed facial nerve, and intracranial complications.

Home mode is prescribed to improve ventilation and drainage function auditory tube and vasoconstrictor drops (naphthyzin, etc.).

General treatment involves the use of antibiotics (eg paracetamol) to stop the inflammation. The course of treatment is 5–7 days. Warm compresses are prescribed locally. In cases where symptoms of irritation appear inner ear(headache, vomiting, dizziness), an incision of the eardrum is indicated, followed by ensuring the outflow of pus.

Mastoiditis and related conditions

Acute mastoiditis is a complication of acute purulent otitis and is an inflammation bone tissue mastoid process, which extends from the tympanic cavity to cellular structure mastoid process through the passage into the cave, in this case there is a disruption of the communication between the skeletal system of the mastoid process and the tympanic cavity. Primary mastoiditis occurs rarely with trauma to the mastoid process, tuberculosis, syphilis or actinomycosis. Secondary mastoiditis develops due to acute purulent otitis. There are exudative and proliferative-alternative stages of mastoiditis.

Main clinical symptoms

TO general symptoms include deterioration of general condition, increased temperature and changes in blood composition, and local symptoms include pain, noise and hearing loss.

During an external examination, hyperemia and infiltration are noted in the area of ​​the mastoid process, the auricle protrudes anteriorly or downward.

On palpation, sharp pain is observed. During otoscopy, mastoiditis is characterized by overhanging of the soft tissues of the posterior superior part of the external auditory canal. The suppuration is pulsating, and pus can fill the ear canal immediately after it is cleared.

The disease is also indicated by the presence of a subperiosteal process.

Diagnostics

The final diagnosis is made based on the results of radiography, showing a decrease in pneumatization, and in more cases late stages the formation of clearing areas due to bone destruction and accumulation of pus.

Mostly conservative and surgery. TO conservative methods include purpose antibacterial agents taking into account the sensitivity of the flora to antibiotics, thermal procedures and physiotherapeutic methods. If there is no positive effect, surgical intervention is recommended.

Inner ear diseases

One of the most common diseases of the inner ear is labyrinthitis - acute or chronic inflammation of a limited or widespread nature and characterized by disorders vestibular apparatus and an auditory analyzer. Labyrinthitis is always a complication of another inflammatory process.

Its main symptoms are associated with dysfunction of the auditory analyzer and vestibular functions.

Held complex treatment, which includes antibacterial and dehydration therapy, as well as the elimination of trophic disorders in the labyrinth and improvement of the general condition of the body. Broad-spectrum antibiotics are usually prescribed, excluding ototoxic effects.

In case of ineffectiveness conservative treatment Surgery is performed within 5–7 days.

Ear diseases are quite common nowadays and are very diverse.

The main causes of ear diseases.

First of all, to the causes of lesions hearing aid factors of an infectious nature must be included. Here are the main ones: hemolytic streptococcus (causes erysipelas of the external ear), Pseudomonas aeruginosa (most often the cause of purulent perichondritis), staphylococcus (furuncle of the external ear, acute and chronic tubo-otitis), streptococcus (inflammation of the eustachian tube, otitis media), pneumococcus ( causes otitis media), molds (cause otomycosis), influenza virus (otitis) and many others, including Mycobacterium tuberculosis (ear tuberculosis) and treponema pallidum (ear syphilis).

These infections can themselves cause inflammatory lesions of the ear, or be complications of inflammatory processes in other organs - these include lesions of the sinuses (acute and chronic sinusitis, sinusitis), as a result of tonsillitis, scarlet fever, influenza and others.

Factors such as ear microtraumas, decreased local and general immunity, improper ear hygiene, and allergic reactions. Also, these infectious lesions, in addition to inflammatory processes, can further cause complications and cause sensorineural hearing loss.

For other reasons, causing diseases ear should be noted about the increased function of the glands of the auditory canal, as a result of which, with improper hygiene, a cerumen plug may occur.

Some medications (antibiotics of the aminoglycosin group) have a toxic effect on the ear.

Ear injuries are also common: mechanical (bruise, blow, bite), thermal (high and low temperatures), chemical (acids, alkalis), acoustic (short-term or long-term exposure to strong sounds on the ear), vibration (due to exposure to vibration vibrations produced by various mechanisms), barotrauma (when atmospheric pressure changes). Ear lesions can also be caused by foreign bodies(most often in children, when they push buttons, balls, pebbles, peas, paper, etc. into themselves; less often in adults - fragments of matches, pieces of cotton wool, insects).

Other reasons include genetic mutations, resulting in congenital anomalies development of the hearing aid.

Symptoms of ear diseases.

One of the main clinical manifestations ear diseases will cause pain. Most often it occurs in inflammatory diseases of the auditory analyzer. It can be different (very strong with a boil, or weak with eustachitis), it can radiate to the eye, lower jaw, occur during chewing, swallowing, and there may also be a headache on the affected side.

Quite often with inflammatory lesions there is hyperemia (redness) of the ear, swelling auricle and fluctuation (in the presence of pus).

In addition to these local manifestations, general manifestations are also often encountered: increased body temperature, chills, decreased appetite, bad dream. In allergic diseases, burning and itching in the ear occur (with eczema).

Symptoms such as a sensation of liquid transfusion or splashing often occur when moving the head.

Discharge from the ear is also common; it can be putrefactive (with eczema), purulent constant and periodic (with otitis), bloody (with malignant neoplasms), bloody-purulent, serous, which can be with or without odor.

Also, with various ear diseases, patients complain of hearing loss, noise in the ear, autophony (perception of one’s own voice in a blocked ear), hearing loss (any weakening of auditory function) to various sound frequencies, the severity of which depends on the activity of the inflammatory process in the ear, deafness ( complete absence ability to perceive sounds), dizziness accompanied by vomiting (with lesions of the vestibular apparatus).

Upon examination, you can identify redness and swelling of the outer ear, see scratching on the outer ear and in the ear canal, small blisters, and grayish-yellow crusts. During palpation, evaluate the pain symptom in more detail, in which exact place it hurts, where the pain goes, how hard you need to press for the pain symptom to occur.

Ear research methods.

External examination and palpation of the ear. Normally, palpation of the ear is painless, but with inflammatory lesions pain appears.

Otoscopy is performed using an ear funnel, with inflammatory diseases changes in the ear canal occur, you can see various discharge, crusts, scratches, various lesions The eardrum also changes (normally it should be gray with a pearlescent tint).

Determination of the patency of the auditory tubes. This study is based on blowing and listening to the sound of air passing through the patient's auditory tube; 4 methods of blowing are performed sequentially to determine the degree of patency of the auditory tube.

The first method, Toynbee's method, allows you to determine the patency of the auditory tubes when making a swallowing movement performed with the mouth and nose closed.

The second method, the Valsalva method, takes a deep breath, and then intensifies inflation with the mouth and nose tightly closed; in case of diseases of the mucous membrane of the auditory tubes, this experiment is not successful.

The third method, the Politzer method, and the fourth method is blowing out the auditory tubes using catheterization; in addition to diagnostic methods, these methods are also used as therapeutic ones.

Study of the functions of the auditory analyzer. Speech hearing test. Study of whispering and colloquial speech. The doctor pronounces the words in a whisper, first from a distance of 6 meters, if the patient does not hear, then the distance is reduced by one meter and so on, a study with spoken speech is carried out in a similar way.

Study with tuning forks, using tuning forks, air conduction and bone conduction are examined. Experiments with a tuning fork, Rinne’s experiment, compare air and bone conduction, a positive experience if air conduction 1.5 - 2 times higher than bone, negative is the opposite, positive should be normal, negative - in case of diseases of the sound-conducting apparatus.

Weber's experience, they place a sounding tuning fork in the middle of the head and normally the patient should hear the sound equally in both ears; with a unilateral disease of the sound-conducting apparatus, the sound is lateralized in sore ear, with a unilateral disease of the sound-receiving apparatus, the sound is lateralized to the healthy ear.

Jelle's experiment determines the presence of otosclerosis. Bing's experiment is carried out to determine the relative and absolute conductivity of sound through bone. Federici's experience: a normally hearing person perceives the sound of a tuning fork from the tragus longer than from the mastoid process; if sound conduction is impaired, the opposite picture is observed.

Hearing examination using electroacoustic equipment, the main objective of this study is to comprehensively determine hearing acuity, the nature and level of its damage in various diseases. They can be tonal, speech and noise.

Study of the function of the vestibular apparatus. Study of stability in the Romberg position, with disorders of the vestibular apparatus, the patient will fall. The study is in a straight line; in case of violations, the patient deviates to the side. An index test; if there is a violation, the patient will miss. To determine nystagmus (involuntary oscillatory movements of the eyes), the following tests are used: pneumatic, rotational, caloric.

To study the function of the otolithic apparatus, an otolith test is used.

Other methods used to examine the ear include: x-ray method. In particular, to identify traumatic injuries (fractures of the styloid process, mastoid process temporal bone), to identify various benign and malignant tumors of the auditory analyzer. For this purpose, both conventional radiography and computed tomography and magnetic resonance imaging are used.

You can also take discharge from the ear for research to determine the pathogen that caused a particular disease and subsequently determine its sensitivity to antibiotics for proper treatment.

A complete blood count also helps in diagnosing ear diseases. In cases of inflammatory damage to the ear, there will be leukocytosis in the blood, an increase in the erythrocyte sedimentation rate.

Prevention of ear diseases.

Prevention of these diseases (especially of an inflammatory nature) is based on careful adherence to personal and ear hygiene, timely and correct treatment diseases of other organs, especially those located nearby: the nose, paranasal sinuses, pharynx (this especially applies to childhood, in which quite often the cause of ear diseases is the adenoids, which close the mouths of the auditory tubes and thereby disrupt the ventilation of the middle ear), the fight against chronic infections, if the patient has a deviated nasal septum, hypertrophy of the nasal turbinates, or polyps, surgical interventions must be performed to restore the functions of the upper respiratory tract and auditory tube, from the common preventive measures should indicate the hardening of the body.

To prevent inflammatory lesions of the inner and middle ear, timely treatment of inflammatory diseases of the outer ear should be noted. When working with chemicals observe safety precautions use individual means protection.

To prevent acoustic injury, undergo annual medical examinations; if deviations are detected, it is better to change jobs, and at work use personal protective equipment (ear pads, tampons, helmets) and ensure that the room is equipped with sound-absorbing and sound-insulating means.

To prevent barotrauma, take precautions to ensure slow changes in atmospheric pressure.

To prevent vibration injuries, measures are taken for vibration isolation, vibration absorption, and vibration damping.

If any symptoms associated with auditory analyzer, it is necessary to consult a specialist to prevent complications, one of which may be deafness, by starting treatment correctly and in a timely manner.

Diseases of the ear and mastoid process in this section:

Diseases of the external ear
Diseases of the middle ear and mastoid process
Inner ear diseases
Other ear diseases

Mastoiditis is a disease that many people face. But not every person knows what the mastoid processes are and where they are located. What is the structure of this part of the temporal bone? How dangerous is the inflammation of these structures, and what can cause the disease? Many people are interested in these questions.

Where are the mastoid processes located?

The mastoid process is bottom part temporal bone. If we talk about its location, it is located below and behind the main part of the skull.

The process itself has the shape of a cone, the base of which borders the area around the middle cranial fossa. The apex of the process is directed downwards - some muscles are attached to it, in particular the sternocleidomastoid muscle. The base of the cone borders the dura mater of the brain (which is why infectious inflammation This area is so dangerous, because pathogenic microorganisms can penetrate directly into the nerve tissue).

It is worth noting that the mastoid processes may have different shapes. For some people they are long with a narrow warp, for others they are short, but with wide base. This anatomical feature largely depends on genetic inheritance.

Structure of the mastoid process

As already mentioned, this part of the temporal bone is shaped like a cone. In modern anatomy, it is customary to distinguish the so-called Shipo triangle, which is located in the anterosuperior part of the process. At the back, the triangle is bounded by the mastoid crest, and at the front, its border passes at the back of the external auditory canal.

The internal structure of the process is somewhat reminiscent of a porous sponge, since there are many hollow cells, which are nothing more than air-bearing appendages of the tympanic cavity. The number and size of such cells can vary and depend on the characteristics of the growth and development of the organism (for example, in childhood leaves its mark on the structure of the mastoid process).

The area contains the largest cell called an antrum or cave. This structure is formed due to close interaction with the tympanic cavity and is present in every person (unlike smaller cells, the number of which can vary).

Types of mastoid processes

As already mentioned, the mastoid process of the temporal bone can have different internal structure. In the first year of a baby's life, the antrum forms. Up to three years of age, active pneumatization of the internal tissues of the appendix occurs, which is accompanied by the appearance of hollow cells. By the way, this process lasts throughout a person’s life. Depending on the number and size of cavities, it is customary to distinguish several types of structure:

• Pneumatic mastoid processes are characterized by the formation of large cells that fill the entire interior of this bony structure.
• With the sclerotic type, there are practically no cells inside the process.
• In the diploetic mastoid process there are small cells that contain a small amount of bone marrow.

It is worth noting that most often doctors find traces of mixed formation of cavities in this part of the temporal bone. Again, everything here depends on the genetic characteristics of the body, the pace of development, as well as the presence of injuries and inflammatory diseases in childhood and adolescence.

Inflammation of the mastoid process and its causes

A disease in which inflammation of the tissues of the mastoid processes occurs is called mastoiditis. The most common cause is infection, and pathogens can enter this area of ​​the skull in different ways.

Most often, this disease develops against the background of otitis media. The infection enters the mastoid process of the temporal bone from the tympanic cavity or auditory canal. In some cases, inflammation develops due to direct trauma to the skull in the temple or ear area. The source of infection may be those in this area. Much less commonly, the cause of the disease is systemic blood infection.

Main symptoms of inflammation

The main symptoms of mastoiditis largely depend on the severity and stage of development of the disease. For example, at the initial stages it is very difficult to distinguish inflammation of the mastoid process from ordinary otitis media.

Patients complain of sharp, shooting pain in the ear. There is an increase in temperature, weakness and body aches, and headaches. Discharge appears from the ear canal.

In the absence of treatment or insufficient treatment (for example, stopping antibiotics too quickly) clinical picture is changing. The mastoid process of the ear gradually fills with pus, and under pressure the bone partitions between the cells are destroyed. The skin and subcutaneous tissues swell and turn red, become hard and hot to the touch. Ear ache becomes stronger, and thick purulent masses are released from the ear canal.

Inflammation from the mastoid cavities can spread under the periosteum - pus accumulates in the layer subcutaneous tissue. Quite often, the abscess ruptures on its own, resulting in the formation of a fistula on the skin.

How dangerous can the disease be? The most common complications

As already mentioned, the mastoid process is located behind the ear and borders important organs. Therefore, the lack of timely therapy is fraught with dangerous consequences. If the lesion breaks into the cavity of the middle and inner ear, labyrinthitis develops. Inflammation of the inner ear is accompanied by tinnitus, hearing loss, and damage to the balance organ, which leads to impaired coordination of movements.

The mastoid processes border on hard shells brain. The infection can spread to nerve tissue, leading to the development of meningitis, encephalitis, and sometimes abscesses.

The penetration of infections into the vessels responsible for the blood circulation of the brain is dangerous - this is fraught not only with inflammation vascular walls, but also the formation of blood clots, blockage of arteries and even death.

Complications of mastoiditis include damage to the facial nerve. After all, the mastoid process behind the ears is very close to the nerve fibers.

How is mastoiditis treated?

As you can see, mastoiditis is extremely dangerous disease, so adequate therapy is simply necessary here. Any delay and attempts at self-medication can lead to a lot of dangerous complications.

As a rule, treatment is carried out in a hospital setting, where the doctor has the opportunity to constantly monitor the patient’s condition. Patients are prescribed intravenous administration antibiotics to help fight bacterial infection. In addition, it is necessary to create conditions for the free exit of purulent masses from the ear canal.

When is trepanation of the mastoid process necessary?

Unfortunately, conservative therapy is effective only in the initial stages of mastoiditis. If pus begins to accumulate in the cavities of the lower part of the temporal bone, then simple surgical intervention is necessary. Trepanation of the mastoid process begins with opening the bone wall of the process. After this, the surgeon, using instruments, cleanses the tissues of pus and treats them with antiseptics and antibacterial solutions. Then a special drainage system is installed, which ensures easy and quick removal of secretions, as well as local administration of antibiotics.

Represents the lower part of the temporal bone. If we talk about its location, it is located below and behind the main part of the skull.

The mastoid process has the shape of an inverted cone with the apex facing downwards and the base facing upwards. The shape and size of the process are very diverse. It distinguishes between the outer and inner surfaces.

Its outer surface (planum mastoideum) is more or less smooth, only the apex is rough from the attached m. sterno-cleido-mastoideus. Upper limit The process serves as linea temporalis, which forms a posterior continuation of the zygomatic arch and corresponds to the bottom of the middle cranial fossa.

Below the linea temporalis, at the level of the external auditory canal and immediately behind it, on the planum there is a small flat fossa - fossa mastoidea. The upper-posterior wall of the external auditory canal almost always has a spine - spina supra meatum seu spina Henle, and behind it a fossa - fossa supra meatum. They are very important reference points during mastoid surgery.

The mastoid process is absent at birth. The bony walls of the tympanic cavity and antrum consist of infantile diploetic bone, i.e. bone with red lymphoid bone marrow. From the growth of this bone the mastoid process is formed.

Lymphoid Bone marrow turns into mucous: lymphoid cellular elements disappear in it. Mucous bone marrow is completely similar to myxoid tissue. When the bone walls are reabsorbed, the mucous bone marrow finds itself in the same conditions as the embryonic myxondal tissue immediately after birth.

In the walls of the air cavities, under the influence of irritation, the epithelial cover is disrupted, deep air gaps are formed - the beginning of new air cavities. This process moves gradually deeper along with the growth of the mastoid process.

In weakened children (rickets, tuberculosis, etc.), the course of the process is slowed down; remnants of myxoid tissue in the form of layers of loose connective tissue on the walls of the cavity, preservation of diploetic bone and delayed pneumatization are observed at a later date. In most cases, myxoid tissue disappears in the first year or early years of life.

With age, myxoid tissue becomes significantly denser, forming cords and bridges in the tympanic cavity and antrum. With purulent inflammation, these cords and bridges create significant obstacles to the free outflow of pus from the ear and therefore can be one of the reasons for the transition acute otitis into chronic.

These structural features of the mucous membrane of the middle ear in newborns are of great practical importance. The presence of myxoid tissue, which provides a favorable environment for microorganisms and is easily subject to purulent decay, determines the frequency of purulent otitis in newborns and infants.

Types of mastoid

According to their internal structure, the mastoid processes are divided into three types:

1. pneumatic - with a predominance of large or smaller cells containing air;
2. diploetic - with a predominance of diploetic tissue;
3. mixed - diploetic - pneumatic.

The first type is observed in 36%, the second in 20%, and the third in 44% (according to Zuckerkandl). Often there are mastoid processes with dense bone, or so-called sclerosed, without cells and without diploeticity. Many authors do not find such processes are identified as a special type, and are considered as a consequence of long-term, chronic inflammation in the middle ear and in the process.

Diseases that cause mastoid pain

In acute purulent inflammation of the middle ear, the process sometimes spreads to the cells of the mastoid process, melting their septa and forming cavities filled with granulations or pus: acute mastoiditis develops.

Bone destruction can occur both towards the surface of the cortical layer of the mastoid process, and towards the middle and posterior cranial fossae. In the last 10-15 years, mastoiditis has become less common due to the highly successful treatment of acute inflammation of the middle ear with antibiotics.

Increased temperature (from low-grade to 39-40°), pain in the mastoid process, headache, insomnia, pulsating noise and ear pain. In the ear canal, a lot of thick, viscous pus is found, released through a perforation of the eardrum, as well as hanging down of the posterior superior wall of the bony part of the ear canal; There is pain on palpation of the mastoid process.

When the outer bone plate is destroyed, pus from the mastoid process penetrates under the periosteum and soft integument. Subsequently, a subperiosteal abscess of the mastoid process is formed. Complications: facial paralysis, inflammation of the inner ear, intracranial complications and sepsis.

When recognizing, it is necessary to exclude a furuncle of the auditory canal, in which the hearing is not changed, the outer cartilaginous part of the auditory canal is narrowed and sharp pain is observed when pressing on the tragus or when pulling the auricle, which does not happen with acute mastoiditis.

Treatment is the same as for acute purulent inflammation of the middle ear. The use of antibiotics is mandatory. In case of failure - surgery in a hospital setting

Mastoid pain may be a symptom

Questions and answers on the topic "Mastoid process"

Question:Good afternoon For a year now sharp pains above the ear on the right, there is pain radiating to the right back of the head. CT conclusion: “CT picture of the formation of a fatty structure in the mastoid process, probably a lipoma.” What is this and could it cause it? severe pain. Is surgery required? Thank you.

Answer: Lipoma (wen) - benign tumor, developing from adipose tissue. Lipoma is a capsule filled with adipose tissue. Conservative treatment is not suitable in this case. Held surgery removal. Subcutaneous lipomas are removed under local anesthesia together with the capsule, deeper ones - under general anesthesia.

Question:Hello, I have pain on palpation at the site of attachment of the muscle to the mastoid process, but there are no other symptoms yet.

Answer: You need an in-person consultation with an ENT specialist for an examination.

Question:MRI signs of inflammatory changes in the mastoid process of the left temporal bone, 6 year old child, can this be treated with medication?

Answer: Mastoiditis - purulent inflammation acute form mastoid process of the temporal bone, in the area behind the ear. Treatment of mastoiditis in children is carried out based on the following important points: the age of the child; medical history; general health; course of the disease. In most cases, the child is given a course of antibiotics. If conservative treatment is ineffective and there are complications, surgery is performed.

Question:Hello, my X-ray revealed sclerosis of the mastoid process, and there is noise in my left ear. Tell me how to remove the noise? Thank you.

Answer: Hello. Tinnitus may be associated with various diseases, for diagnosis and treatment, it may be necessary to contact not only an ENT specialist, but also an audiologist, psychiatrist, angiosurgeon, neurosurgeon, and neurologist.

Question:Hello. An MRI gave the diagnosis: right-sided mastoiditis. Is it necessary to go to the doctor? How should it be treated?

Answer: Hello. Indeed it is dangerous disease, which must be treated while it is not yet fully developed in a person. Mastoiditis can cause serious pain, suppuration, and hearing problems. It has several stages, the earlier it is diagnosed, the easier and faster it is treated.

Question:Hello! I was admitted to the hospital with a diagnosis of acute suppurative otitis media. It turned into mastoiditis, surgery was performed, the wound was kept open for 5 weeks, then bioglass was inserted. A week later, the cartilage of the auricle swelled. They pulled out the bioglass and kept the wound open for a month, then simply stitched it up. A day after being discharged, I had perichondritis again. Is this disease even curable?

Answer: Hello. Inflammation of the mastoid process of the temporal bone and air cells, including the mastoid cave (mastoid antrum), which communicates with the cavity of the middle ear. The cause of inflammation is usually bacterial infection, spreading from the middle ear. Treatment is usually carried out with antibiotics, but in advanced cases there is sometimes a need for surgical intervention. This disease can be treated. You must strictly follow your doctor's recommendations. If you doubt that the treatment was not provided to you properly, I advise you to contact another attending physician, who, after examining you, will diagnose you and prescribe you treatment.

Question:Hello! Can I get mastoiditis after a head injury?

Answer: Hello. In case of injury, there is a high probability of damage to the periosteum covering the mastoid process, which can cause pain.

Question:Hello! My mother is 69 years old, she has had headaches for 45 years, and has been on painkillers all her life. Twice a year there is an exacerbation: the pain is very strong, paroxysmal, this can last a month, then it gets easier. Who has not been examined and what diagnoses have not been made, from migraine to Arnold Chiari Syndrome. Yesterday, after another MRI, I was diagnosed with right-sided mastoiditis. As long as I remember, she always complained of pain behind her ear during an exacerbation. Can such a diagnosis be hidden like that? Has mastoiditis really not shown itself for decades? Thank you!

Answer: Hello. For accurate diagnosis of ear pathology and detection of mastoiditis, the CT method is used ( CT scan) temporal bones. Your mother probably had an MRI (magnetic resonance imaging) of her brain; these images can lead to an erroneous conclusion. In any case, only a doctor can make a diagnosis clinical practice, in your case - an ENT-otosurgeon, based on the patient’s complaints, his medical history, examination data of the ENT organs, as well as test results (blood, etc.). Mastoiditis is a complication of otitis media, when the inflammatory process extends beyond the middle ear into the cells of the mastoid process of the temporal bone. As a result of bone destruction, the inflammatory process can spread to the membranes of the brain and cause complications such as meningitis, encephalitis, and brain abscess. Treatment is only surgical.

Question:Hello! My mother (47 years old) developed noise in her ear about 10 years ago. She went to the hospital and was told there was inflammation of the Eustachian tube and otitis media. We treated it, the noise did not go away. After 3 years, she again went to the same hospital under a scalpel, because... pus accumulated in the mastoid process of the temporal bone of the skull, which was removed surgically. Nothing has changed in terms of hearing: both the noise and weak hearing remain. They carried out catheterization, but the catheter simply came out on its own after a few days, and nothing came out of the ear through it. Over the last 2 weeks, she began to have pus coming out of her ear; this symptom was also supplemented, as the doctor said, by inflammation of the facial nerve, her mouth, eye, eyebrow, and the entire left side of her face (there was an operation on this bone on the left) was “distorted.” Yesterday I had an MRI, which showed inflammation in the mastoid process of the temporal bone of the skull - mastoiditis. She is currently being treated for inflammation of the facial nerve. prescribed antibiotics. Question: if damage to the facial nerve is a complication of inflammation of the middle ear, then why is the complication treated, and not the cause of the disease? What treatment should she receive at this time? After neuralgia, where is she now, does she need to see an ENT doctor and what is the likelihood that she will need surgery again?

Answer: Hello. Repeated surgery on the mastoid process will be necessary if purulent swelling of this area persists. For neuritis of the facial nerve, it is necessary to carry out timely treatment- delay in treatment can lead to irreversible consequences. We are unable to assess the adequacy of the treatment provided for objective reasons.