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Had A Viral Ear Infection, Blood Blisters On Ear Drum. MRI Showed No Fluid Is Mastoid. Am I Getting Cured?

Posted on Wed, 29 Aug 2012

Question: Hi

6 months back I had a viral ear infection. I had blood filled blisters on my ear drum. Fluid (lot of blood + pus) got accumulated in my middle ear after those bursted and for that a grommet was inserted after 20 days of the infection. My hearing returned to normal but since then I am having pain in my TMJ region. My grommet was taken out after 2 months of its insertion since my doctor found it unnecessary. My MRI /CT shows minimal fluid in my mastoid. I also had a bone scan and the last phase of it (SPECT) came to be positive. I have been put on IV antibiotics (Piptaz + Oflox) for 3 weeks and then had 3 weeks of oral ciprofloxcin. My MRI after antibiotic shows no fluid in mastoid. Only the last phase of bone scan is still positive. When I asked the nuclear medicine doctor about the report, he told me its just a osteoblastic response and no active infection. He explained that had it been active bone infection (osteomyelitis) it should have come in all the three phases of the scan. He told it takes time for the bone scan to be normal.
I have a dull pain around my ear and sometimes this goes to my temple region. My preauricular jaw region is stiff and pains when pressed hard. However I don't have any pus coming out of my ear and my TM is fine according to my ENT.
I wanted to know if I am healing or is there still infection.
Please let me know if you require any more information.

Thanks,
XXXXXX

Answered by Dr. Pravin Banodkar (2 hours later)

Hello
Welcome and thanks for your question
I would be pleased to help you with your Question

From your reports done it looks like you are on the healing phase. The dull pain felt around the TMJ might be due to the inflammation around the area which might be a residual inflammation.
I would suggest you can take an anti inflammatory from your Doctor for daily intake to reduce the inflammation and hence the pain . Your doctor was right when he mentioned that it takes times for the bone scan to become normal .

Thanks and Take care

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

Follow up: Dr. Pravin Banodkar (11 minutes later)

Hello Sir,

Thanks for your reply. Is it advisable for me to go for a surgical debridement of mastoid, TMJ and surrounding areas at this stage?

Thanks,
XXXXXXX

Answered by Dr. Pravin Banodkar (5 minutes later)

Thanks for your reply .

Since you have had an infection , there is always a possibility of Chronic infection . A surgical debridement will help , only if there is something detected on a Scan . An intake of a long term anti inflammatory medication would help at present.

Thanks and Take care

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

Follow up: Dr. Pravin Banodkar (42 hours later)

Hi,

I had my CT scan which shows - "subtle soft tissue opacification" in my posterio-inferior mastoid air cells. Please explain what it means. Am I suffering from any serious disease?

Regards,
XXXXXXX

Answered by Dr. Pravin Banodkar (51 minutes later)

Thanks for the follow up query .

The CT scan reports means that there is an inflammation of the mastoid called Mastoiditis .
It will need to be treated.A surgical debridement will help. An intake of a long term anti inflammatory medication would help at present.
Thanks and Takecare

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

Follow up: Dr. Pravin Banodkar (16 minutes later)

As mentioned earlier I have taken 6 weeks of antibiotics just completing the course 2 weeks ago. Should I go for debridement immediately or should I wait for some time? Which is a better option - surgical debridement or long term anti inflammatory?

Answered by Dr. Pravin Banodkar (32 minutes later)

Thanks for the query .

Surgical Debridement would be a better option than a long term anti inflammatory. An antibiotic cover also at the same time would be essential.
Thanks and take care

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