Mastoid bone infection

As acquired or congential cholesteatomas increase in size, they can also affect the nerve that moves the face, the facial nerve. This nerve extends from the brain to the face by going through the inner ear, the middle ear, exiting near the forward tip of the mastoid bone, rising up to the front of the ear, and finally branching into the upper and lower face. Infected cholesteatomas may erode the bone covering this nerve. Pressure or irritation by the cholesteatoma on the facial nerve may then result in facial weakness or actual paralysis of the face on the side of the involved ear. In this case, ear surgery may be necessary on an emergency basis to prevent permanent facial paralysis.

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Teaching mastoid surgery with binocular operating microscope and KTP LASER Before antibiotics, mastoid surgery was commonly done in desperate circumstances for acute infection, a mastoid abscess. Our predecessors had nothing better than a hammer and gouge, and no magnification other than some spectacle loupes. It was counted a success if the patient – usually a young child – survived. No delicate work could be done, and most survivors were deafened. It was only after the introduction of the binocular operating microscope in the 1950’s that modern delicate controlled microsurgery of the ear became possible. Even with all the latest high powered microscopes, lasers and modern anaesthetics, mastoid surgery is very difficult. Surgeons have to train for years to get good at it. Like all ear surgeons trained since the 1960’s I did my basic training (in the 1980’s) on temporal bones from cadavers (dead bodies). Although some might find that macabre, I’d prefer the learning curve to be on my dead granny, rather than on my live child. The margin of error in mastoid surgery is measured in fractions of a millimetre. Anatomy varies considerably, and a surgeon needs to practice on lots of bones before embarking on live patients. Simulators and plastic bones just aren’t up to it. Unfortunately, in the UK, a public attitude has become established against the use of post-mortem tissues, which has led to a severe shortage of temporal bones for the next generation of ear surgeons to train on. I teach trainee surgeons ear surgery on live patients every week, sometimes two or three cases. The operations take anywhere between one to six hours. The average is around three hours.

  Ear Ant:  The picture on the far right shows a dried ant on top of the eardrum.  Notice the serous fluid behind the eardrum in the lower portion of the middle ear.  The picture in the middle shows a bug embedded in ear wax. The far left picture shows a large bug impacted in the ear canal.    Click on Pictures to Enlarge
 

   
Ear Maggots:   This is a very rare condition.  The patient had an insect which  lodged in the ear  and laid eggs.  The parent insect was dead in the ear along with six baby maggots.

 

Click on Pictures to Enlarge  
 
Leeches used to reattach the outer ear:   When the outer ear or auricle  is avulsed during a traumatic accident, it must be reattached as a "free" graft.  At first there is no blood supply.  The arteries attach first, after 24 hours, but the blood cannot get out of the graft.   The graft will fill with blood and die unless it is drained.  Leeches not only drain the blood, but also secrete an anticoagulant which will aid in continued blood drainage.   View Article Maggots In Medicine - USA Today
 
Click on Pictures to Enlarge

Endochondral ossification begins with points in the cartilage called "primary ossification centers." They mostly appear during fetal development, though a few short bones begin their primary ossification after birth . They are responsible for the formation of the diaphyses of long bones, short bones and certain parts of irregular bones. Secondary ossification occurs after birth, and forms the epiphyses of long bones and the extremities of irregular and flat bones. The diaphysis and both epiphyses of a long bone are separated by a growing zone of cartilage (the epiphyseal plate ). At skeletal maturity (18 to 25 years of age), all of the cartilage is replaced by bone, fusing the diaphysis and both epiphyses together (epiphyseal closure). [ citation needed ] In the upper limbs, only the diaphyses of the long bones and scapula are ossified. The epiphyses, carpal bones, coracoid process, medial border of the scapula, and acromion are still cartilaginous. [28]

In children, infections of the ears can sometimes (although rarely) cause inner ear damage that can lead to changes in hearing. So look out for any signs of hearing loss, and discuss anything unusual you notice with your doctor right away. If you do give your child a low dose of an over-the-counter painkiller to reduce symptoms, be careful not to use aspirin. Aspirin has anti-inflammatory effects but isn’t always well-tolerated by children and teenagers, so use ibuprofen unless a doctor has prescribed another drug or — preferably — natural pain relievers if you can.

Mastoid bone infection

mastoid bone infection

  Ear Ant:  The picture on the far right shows a dried ant on top of the eardrum.  Notice the serous fluid behind the eardrum in the lower portion of the middle ear.  The picture in the middle shows a bug embedded in ear wax. The far left picture shows a large bug impacted in the ear canal.    Click on Pictures to Enlarge
 

   
Ear Maggots:   This is a very rare condition.  The patient had an insect which  lodged in the ear  and laid eggs.  The parent insect was dead in the ear along with six baby maggots.

 

Click on Pictures to Enlarge  
 
Leeches used to reattach the outer ear:   When the outer ear or auricle  is avulsed during a traumatic accident, it must be reattached as a "free" graft.  At first there is no blood supply.  The arteries attach first, after 24 hours, but the blood cannot get out of the graft.   The graft will fill with blood and die unless it is drained.  Leeches not only drain the blood, but also secrete an anticoagulant which will aid in continued blood drainage.   View Article Maggots In Medicine - USA Today
 
Click on Pictures to Enlarge

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