Mastoiditis refers to an infection that occurs in the cavities of the mastoid process of temporal bone after otitis media. At birth, the mastoid consists of a single cavity, which is connected to the middle ear by a canal. As the child grows, the mastoid bone becomes pneumatized, resulting in a series of connected cavities lined by a mucosa derived from respiratory epithelium. The connection between the middle ear, the eustachian tube, and the mastoid has a fundamental role in the pathogenesis of mastoiditis. In the setting of acute otitis media, the mucosa that lines the middle ear and mastoid air cells become inflamed. In a majority of cases of acute otitis media, inflammation resolves; when it persists, it leads to bacterial and fluid accumulation within the mastoid air cells. Gradually, as a result of pressure rising in the mastoid, air cell septae may be destroyed and mastoiditis could proceed to periostitis, cavity abscess, and osteomyelitis. The mastoid is near vital organs in the head and neck and mastoid infection may cause serious complications. There is evidence of a genetic predisposition to recurrent otitis media, and therefore mastoiditis, with statistically significant evidence that it has high heritability. The following genes have been identified as having potential pathogenic qualities for otitis media: CAPN14, GALNT14, BPIFA3, BPIFA1, BMP5, GALNT13, NELL1, and TGFB3.
Mastoiditis pathophysiology
Mastoiditis causes
Mastoiditis risk factors
Mastoiditis classification
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