Complications of Mastoiditis
The complications of mastoiditis can be serious and potentially life-threatening if the infection is not treated promptly and effectively. Complications of mastoiditis arise when the infection spreads beyond the mastoid bone, impacting surrounding tissues, structures of the ear, and even other parts of the skull and brain. While many cases of mastoiditis respond well to antibiotics and drainage, failure to diagnose or manage the condition quickly can lead to an array of medical consequences that may affect a person’s hearing, neurological function, and overall health.
Hearing Loss
One of the most common complications of mastoiditis is hearing loss. The mastoid bone connects closely to the middle ear. When it becomes inflamed or infected, the delicate hearing parts may suffer damage. Fluid buildup, damage to the tiny ear bones, or scarring of the eardrum can block sound transmission.
At first, this hearing loss may be temporary if caused by fluid or pressure. Yet, permanent damage to the cochlea or the hearing nerve may cause sensorineural hearing loss, which usually does not improve.
Sometimes, surgery like mastoidectomy (removing infected mastoid cells) or tympanoplasty (repairing the eardrum) can restore some hearing. Even so, some patients may still need hearing aids or other devices if the loss remains severe or permanent.
Facial Nerve Paralysis
Another alarming complication is facial nerve paralysis. The facial nerve passes through the temporal bone, which also contains the middle ear and mastoid air cells. If mastoiditis spreads or forms an abscess inside this bone, the nerve may become compressed or damaged.
This can lead to muscle weakness or paralysis on one side of the face. The person may struggle to close the eye, show expressions, or control mouth movement.
Doctors usually order urgent scans and may need to perform surgery to release pressure. With fast treatment, the nerve can recover slowly. But when treatment is delayed, some permanent weakness may remain.
Labyrinthitis and Vertigo
Infections spreading into the inner ear can cause labyrinthitis. This condition inflames the hearing and balance system. It often brings intense vertigo, dizziness, nausea, vomiting, and poor balance.
Labyrinthitis disrupts daily life and can also leave lasting balance issues or hearing loss. While medicines can calm symptoms for a short time, patients also need antibiotics and sometimes drainage surgery to clear the infection. If vertigo lingers, vestibular physiotherapy can help with recovery.
Intracranial Complications of Mastoiditis
Some of the most dangerous complications of mastoiditis occur when infection spreads inside the skull. These include brain abscess, meningitis, or lateral sinus thrombosis. All of these conditions require emergency care.
Brain Abscess
A brain abscess forms when bacteria move from the infected mastoid bone into the brain. The thin temporal bone wall makes this possible. Symptoms often include a severe headache, confusion, weakness in certain body parts, or seizures.
Doctors confirm diagnosis through scans like CT or MRI. Treatment includes intravenous antibiotics and, in many cases, surgical drainage of the pus.
Meningitis
Meningitis develops when the membranes around the brain and spinal cord become infected. The signs include very high fever, neck stiffness, sensitivity to light, vomiting, and confusion.
Meningitis linked to mastoiditis can progress very quickly. Without rapid treatment with antibiotics and hospital care, it may become fatal.
Lateral Sinus Thrombosis
Lateral sinus thrombosis occurs when a clot forms in the brain’s venous sinuses. This happens if infection spreads from the mastoid to the sigmoid or transverse sinuses. Common symptoms are headache, fever, swelling of the optic disc, and sometimes seizures or vision changes.
Doctors use MRI or MRV scans to confirm the clot. Treatment requires antibiotics and blood thinners to prevent stroke and protect the brain.
Subperiosteal Abscess
Another complication of mastoiditis is a subperiosteal abscess. This happens when pus collects between the mastoid bone and its covering layer. Symptoms often include swelling behind the ear, redness, and the ear lobe being pushed outward.
This abscess usually needs surgical drainage along with antibiotics. If left untreated, the pus may erode bone, spread into neck muscles, or create a tunnel from the mastoid to the skin, leading to chronic drainage and infection.
Chronic Suppurative Otitis Media
In some patients, mastoiditis does not heal fully and turns into chronic suppurative otitis media (CSOM). This is a long-lasting middle ear infection where pus drains through a hole in the eardrum.
CSOM is difficult to cure and may require months of care. Doctors may prescribe ear drops, perform surgery to repair the eardrum, or remove infected tissue.
Ongoing infection can also cause a cholesteatoma, a harmful skin growth in the ear and mastoid. This growth can damage bone, reduce hearing, and spread infection if not removed by surgery.
Delayed Development in Children
In children, complications of mastoiditis affect more than just health. Chronic ear infections and hearing loss can delay speech, language learning, and school progress.
Children who struggle to hear may also face social or behavioural issues. With early diagnosis and regular ENT follow-ups, these risks can be reduced. Proper hearing support ensures children develop normally.
Systemic Infection (Sepsis)
In rare but severe cases, mastoiditis can spread into the whole body and cause sepsis. Sepsis creates a strong inflammatory reaction that harms many organs.
Signs of sepsis include very high fever, fast breathing, low blood pressure, confusion, and even organ failure. This condition needs urgent hospital care with fluids, antibiotics, and support for the heart and circulation. Without quick action, sepsis can be fatal.
