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Paediatric Imaging

Mastoiditis

inflammation of the mastoid air cells commonly associated with otitis media. The antrum of the mastoids is often visible by 2 or 3 months of age and air cells become visible by 3 - 6 months. In mastoiditis (mastoid infection), the air cells become hazy because of mucosal thickening and fluid collection. The adjacent bony walls may become indistinct secondary to inflammatory and hyperaemic demineralization. Mastoiditis can proceed to mastoid abscess formation with bony destruction and may even be complicated by intracranial infection. CT is required to delineate the extent of the infection (see mastoiditis (VI:2), Fig. 1).

Chronic mastoiditis occurs due to recurrent infection which leads to inhibition of mastoid air cell development and aeration.The petrous bone is often sclerosed and in some cases there is virtually no aeration. A complication of chronic mastoiditis is inflammatory cholesteatoma.