Identifying the volumes of the middle ear and the mastoid bone
CT examination revealed soft tissue density completely filling the right external auditory canal, middle ear, and mastoid bone
along with marked edema in the right masticator and buccal space (Figure 1).
In addition, intense bleeding was observed at the mastoid bone
None of the patients had described ear trauma, previous ear surgery, or any disease related to the middle ear or mastoid bone
Mastoiditis, where an ear infection has spread to the mastoid bone
The final histology exam confirmed BSC with perineural involvement, positive margins on dura mater and mastoid bone
and one positive lymph node, undecided between local invasions vs.
After cutting through skin and subcutaneous tissue, the auricular muscles auricularis superior and posterior are generally divided to access and incise the periosteum overlying the mastoid bone
. Depending on the surgery being performed a small amount of temporalis fascia may be harvested, but the underlying muscle is left intact.
One concern this approach raises is an increase in complications such as acute mastoiditis, an infection of the mastoid bone
(the mastoid consists of air spaces and functions to help drain the middle ear).
Further exploration of middle ear and mastoid cavity revealed cholesteatoma eroding all ossicles and involving mastoid bone
. Modified radical mastoidectomy was done (Fig.
Serotype 19A Streptococcus pneumoniae was isolated from the middle ear, the subperiosteal abscess, and mastoid bone
. She responded well to surgical drainage and mastoidectomy with myringotomy tube placement and initial parenteral therapy with vancomycin (plus ceftriaxone), and was transitioned to oral levofloxacin.
Serotype 19A Streptococcus pneumoniae was isolated from the middle ear, subperiosteal abscess, and mastoid bone
. She responded well to surgical drainage and mastoidectomy with myfingotomy tube placement and initial parenteral therapy with vancomycin (plus ceftriaxone), and was transitioned to oral levofloxacin.
She has webbed toes, uses a Bone Anchored Hearing Aid (BAHA), a new type of hearing aid that enters it's sound output into the cochlea by vibrating the mastoid bone
, and also has no tear ducts.
These are connected to a tiny electromagnetic vibrator which is positioned inside the mastoid bone
behind the ear and attaches to the hearing bones.
The device, Philips Sleepwave, is attached to the mastoid bone
behind the ear using a sensor cable and it works by sending electric pulses into the vestibular system.
" Chronic ear infection may sometimes result from an infection of the mastoid bone
, which is located in the inner ear.