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Suffering From Chronic Mastoiditis. Having Dull Pain In Temple, Head And Neck. How To Cure This?

Posted on Mon, 29 Oct 2012

Question: Hi
I have been suffering from chronic mastoiditis. I have the following problems:
1. Dull pain in temple region of head and in the neck.

I had a CT scan done which shows subtle soft tissue opacification in the mastoid. I had a mastoidectomy a month ago. Still I am not getting complete relief. The mastoid glue culture did not reveal anything.
Please advice a good antibiotic that I can take to cure this.
Regards,
XXXXXXX .

Answered by Dr. Raju A.T (12 hours later)

Hi,

Thanks for your query.

The pain in the temple you have is commonly seen in patients after mastoidectomy for a minimum of 2 to 3 months.This is due to the loss of the air cells previously present in the mastoid making the skull light.The skull has to adapt to the lost air cells, hence it does take some time for the same.

Since the glue culture is negative then taking antibiotic is of no use.

Do take anti-inflammatory medication like Tab Motrin 400 mg twice daily for 3 days.This will reduce the pain and provide you some relief.

Hope I answered your query.

Wish you good health.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Raju A.T (1 hour later)

Hi

During mastoidectomy they found some granulation tissue which they sent for HPE. HPE report says - "mildly inflammed fibrocolagenous tissue". What does that mean? Is is a sign of active infection or past infection?
I also have some pain and swelling in my jaw line and TMJ. Can this be due to mastoiditis?

Regards, XXXXXXX

Answered by Dr. Raju A.T (21 hours later)

Hi,

Thanks for writing back.

The HPE reports mentioned above states that there is inflamed scar tissue in the mastoid which indicates that the infection in the mastoid is a chronic (long term) one.

Yes, the pain in the jaw line and the TMJ is due to surgery you underwent on the mastoid.It will limit on its own, there is nothing to worry about the same.

Hope I cleared your doubts.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Raju A.T (3 hours later)

Hi

Thanks for your answer. I have the following questions:

1. You said my infection is chronic. What dangers are there due to this?

2. I had a bone scan done which showed some increased uptake at the last phase only. When I consulted a bone scan specialist he said it is osteoblastic activity in the mastoid. He said since all the 3 phases of the bone scan is not positive (only last phase is abnormal) so there is less chance of active infection.
Is there any reason for worry due to this increased uptake? Will it settle down on its own?

3. I had a pain in the TMJ region before also (before surgery). It has reduced after surgery considerably. Do I need to do anything for this TMJ and jaw line pains? Are they because of spread of the infection?

Regards,
XXXXXXX

Answered by Dr. Raju A.T (13 hours later)

Hi again,

1) No , chronic infection means only that it has been for longer time , it is not as serious as an acute infection (short duration).Chronic infection will have less inflammation and though the damage is for long term is not as severe as in acute infection.

2)Increased Uptake in the OPG (orthopantogram) scan is a sign of activity, activity which can be seen in healing or mild form of inflammation.Either of them can be seen in post surgical status and is not serious.

3)Pain in TMJ is secondary to the defect in the mastoid.This is not due to spread of infection from the mastoid focus.The pain will surely subside after some time.Taking mild pain-killer medications would suffice.

Hope I cleared your doubts.

Wish you speedy recovery.

Regards,

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar