Mastoiditis physical examination

Mastoiditis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Physical Examination

The diagnosis of mastoiditis is clinical—based on the medical history and physical examination. Imaging studies may provide additional information; the study of choice is the CT scan, which may show focal destruction of the bone or signs of an abscess (a pocket of infection). X-rays are not as useful. If there is drainage, it is often sent for culture, although this will often be negative if the patient has begun taking antibiotics.

Gallery

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  Picture of a right mastoidectomy, surgeon's view. Note the blue color of the skeletonized sigmoid sinus.

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  Picture of a left mastoidectomy, surgeon's view.

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  In this left canal wall up mastoidectomy, the tympanic membrane has been elevated forward and a cholesteatoma sac is visible in the attic.

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  This patient has a recurrent cholesteatoma which has found its way to the surface of the post-auricular skin, forming a mastoid cutaneous fistula.

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  This cholesteatoma sac has eroded the lateral surface of the mastoid bone and was found immediately under the post-auricular skin.

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  Left canal wall down mastoidectomy.This patient had a modified radical mastoidectomy with tympanoplasty. The posterior bony canal has been removed and part of the dry "mastoid bowl" is visible posterior and superior to the reconstructed tympanic membrane .

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  Magnification of the previous picture .