- Lowered resistance of patient due to measles, exanthematous fever, poor nutrition and immune-compromising systemic disease.
- High virulence of organism. The most common organism infecting children is pneumococci
- Pain: It is present in the upper part of the neck and the sternomastoid. Neck movements are restricted.
- Ear discharge: The discharge is purulent, profuse and foul smelling.
- Mastoid tenderness is elicited by pressure over the Macewen triangle or suprameatal triangle.
- Perforation of the tympanic membrane.
- Mastoid tenderness elicited by pressure over the Macewan's triangle.
- Conductive type of hearing loss.
- There is usually no fluctuation felt.
- Generalized tender swelling below the pinna.
- This swelling often conceals the contours of the mastoid process.
- X-ray mastoid - Schüller view: It may show lysis and destruction of the mastoid air cells.
- HRCT temporal bone: This indicates the extent of the disease, status of the middle ear, ossicles, and the facial nerve. It also gives an idea of any impending complications.
- Mastoidectomy is required to eradicate the disease in chronic mastoiditis.
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