by EBSCO Medical Review Board
(Acute mastoiditis)


Mastoiditis is swelling or infection of the small air cells in the mastoid bone of the ear. Over time, this can cause the bone tissue to break down.


Mastoiditis is most often caused by a bacterial infection due to a long lasting middle ear infection .

The Middle Ear
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Risk Factors

This problem is more common in young children. Things that may raise the risk are:

  • A weak immune system
  • Recent surgery to remove diseased mastoid air cells


Problems may be:

  • Swelling and redness behind the ear, pushing it forward
  • Fever
  • Ear pain
  • Discharge from the ear
  • Irritability
  • Decreased hearing


The doctor will ask about your symptoms and health history. You will be asked about your history of ear infections. A physical exam will be done. This is often enough to make the diagnosis.


Treatment options are:


Antibiotics will be given to treat infection. This is often done by IV and then by mouth.


Surgery may be needed when medicine does not help. This can be done with:

  • Myringotomy and tympanostomy to drain fluid and place tubes in the ear to keep the middle ear open to prevent fluid build-up
  • Mastoidectomy to remove the mastoid bone


Mastoiditis is most often caused by an ear infection. Getting treated for an ear infection may lower the risk of mastoiditis.


American Academy of Otolaryngology—Head and Neck Surgery 

Healthy Children—American Academy of Pediatrics 


Canadian Society of Otolaryngology—Head and Neck Surgery 

Health Canada 


Acute mastoiditis. EBSCO DynaMed website. Available at:  . Updated July 11, 2018. Accessed December 3, 2019.

Kordeluk S, Kraus M, et al. Challenges in the management of acute mastoiditis in children. Curr Infect Dis Rep. 2015 May;17(5):479.

Mastoiditis. Merck Manual Professional Version website. Available at: Updated March 2019. Accessed December 3, 2019.

Mastoiditis. NHS Choices website. Available at: Updated January 13, 2017. Accessed December 3, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 09/2019
  • Update Date: 12/03/2019