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Richmond's Ear, Nose and Throat Specialists

Mastoiditis & Cholesteatoma


Acute Mastoiditis is an infection of the bone containing the middle ear space.  Mastoiditis can become a serious medical emergency when otitis media is left untreated.  Symptoms of acute mastoiditis may include high fever, redness, and swelling behind the ear.  Acute mastoiditis usually requires urgent placement of myringotomy tubes and hospitalization for intravenous antibiotics.  Fortunately, acute mastoiditis is quite rare in Richmond Virginia.

Chronic mastoiditis can occur despite appropriate medical and surgical management of otitis media.  If the infection spreads into the mastoid bone, the patient will usually experience persistent foul drainage from the ear, which does not respond to antibiotic ear drops. Occasionally, chronic mastoiditis will respond to prolonged courses of oral or intravenous antibiotics.  In many cases the bone must be thoroughly cleaned with a procedure called a mastoidectomy.


A Cholesteatoma is a special type of chronic mastoiditis caused by the development of a skin lined cyst within the middle ear.  The cyst expands within the middle ear space, destroying the bones of the middle ear.  It can erode into the facial nerve, cochlea, or even the brain cavity.  A cholesteatoma almost always requires surgical removal and lifelong ENT followup.

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