What Is Mastoiditis? Symptoms and When to Seek Care

Mastoiditis is a rare but serious condition that can develop as a complication of an ear infection. While it’s most commonly seen in children, adults can also be affected. Because mastoiditis involves infection of the bone behind the ear, it requires prompt medical assessment and treatment to prevent complications. 

This article is intended to help you understand what mastoiditis is, what symptoms to watch for, and when to seek medical care. It does not replace advice from a doctor or specialist, and it’s important not to delay professional evaluation if mastoiditis is suspected. 

• What is mastoiditis?
• What causes mastoiditis?
• What are the symptoms of mastoiditis?
• How is mastoiditis diagnosed and treated?
• Can mastoiditis be prevented?
• When should you seek medical care?
• Understanding mastoiditis and next steps

Note: Our Hearing Care Providers (HCPs) are here to support your hearing health and provide personalized guidance. However, if you're concerned about medical issues affecting your hearing, always consult your healthcare provider first. 

What is mastoiditis? 

The mastoid bone is the hard, prominent bone located just behind and slightly below the ear. Inside this bone are small, air-filled spaces called mastoid cells, which connect to the middle ear. Mastoiditis occurs when these cells become infected and inflamed, most often as a result of a middle ear infection that has not fully resolved. 

Because the mastoid bone is part of the skull, infection in this area is taken seriously. While mastoiditis is uncommon today thanks to antibiotics, it can still occur and should always be evaluated promptly by a medical professional. 

What causes mastoiditis? 

In most cases, mastoiditis develops when a middle ear infection (otitis media) does not respond adequately to treatment or is left untreated. The infection can spread from the middle ear into the mastoid air cells, leading to inflammation of the bone. 

Less commonly, mastoiditis may be associated with other ear conditions that interfere with normal drainage of the middle ear. Common causes or risk factors include: 

• Persistent or recurrent middle ear infections
• Delayed medical treatment for ear infections
• Rare complications such as cholesteatoma

Although mastoiditis is rare, these situations increase the risk and underline the importance of treating ear infections early. 

What are the symptoms of mastoiditis? 

Symptoms of mastoiditis can vary in severity and may worsen over time. Some signs are visible, while others are more general. Because symptoms can overlap with other ear conditions, medical assessment is essential. Common symptoms may include: 

• Pain, tenderness, redness, or swelling behind the ear
• Ear discharge
• Fever
• Headaches

• Fatigue or irritability
• Hearing changes in the affected ear

Not everyone will experience all of these symptoms, but any combination of ear-related symptoms with swelling or fever should be checked by a doctor. 

How is mastoiditis diagnosed and treated? 

Mastoiditis is diagnosed and treated by medical doctors, often starting with a general practitioner (GP) and, if needed, referral to an ear, nose, and throat (ENT) specialist. Diagnosis typically involves a physical examination and may include additional tests to confirm the extent of the infection. 

Treatment usually involves antibiotics, and in some cases hospital care may be required. The exact treatment approach depends on the severity of the infection and the individual patient.  

Management of mastoiditis is not handled by hearing clinics and should always be overseen by medical professionals. Early treatment greatly improves outcomes and reduces the risk of complications. 

Can mastoiditis be prevented? 

In many cases, mastoiditis can be prevented by prompt and appropriate treatment of middle ear infections. Seeking medical care early when ear infection symptoms appear helps reduce the chance of the infection spreading beyond the middle ear. 

Completing prescribed courses of antibiotics and following up with a doctor if symptoms persist are important steps in prevention. While mastoiditis cannot always be avoided, early treatment significantly lowers the risk. 

When should you seek medical care? 

You should seek medical care urgently if you or your child experience ear infection symptoms that do not improve, or if new symptoms develop around the ear. Mastoiditis should always be assessed by a doctor rather than monitored at home. Seek medical attention promptly if: 

• Swelling, redness, or pain develops behind the ear
• Fever accompanies ear symptoms
• Ear discharge persists or worsens
• Hearing changes occur following an ear infection

Early evaluation allows treatment to begin before the condition becomes more serious. 

Understanding mastoiditis and next steps 

Mastoiditis is uncommon, but it is a condition that requires prompt medical attention. When treated early, outcomes are generally very good. The most important thing to remember is that mastoiditis should never be self-diagnosed or monitored at home—any suspected symptoms should be assessed by a doctor as soon as possible. 

While Connect Hearing does not diagnose or treat mastoiditis, hearing care can play a role after medical treatment, particularly if hearing changes are noticed during recovery. Medical care should always come first, with hearing assessment as a follow-up step when appropriate. 

Key takeaways 

• Mastoiditis is a rare but serious complication of middle ear infections.
• It most often develops when ear infections are persistent or untreated.
• Symptoms can include pain, swelling, fever, discharge, and hearing changes.
• Mastoiditis must be diagnosed and treated by a medical doctor or ENT specialist.
• Early medical treatment greatly reduces the risk of complications.

If you’ve recently had an ear infection and later notice changes in your hearing, a hearing assessment can help evaluate your hearing health after your doctor has confirmed the infection has resolved. You can book a free hearing test or find a clinic near you for follow-up support when appropriate.