Chronic otomastoiditis is defined as persistent or recurrent inflammation of the middle ear (chronic otitis media) and mastoid, lasting usually for a minimum of 12 weeks, often resulting in permanent perforation of the tympanic membrane. It should be considered a separate entity from acute otomastoiditis.
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Clinical presentation
Patients typically present with conductive hearing loss, chronic pain, otorrhoea and vertigo.
Pathology
It is thought to be primarily due to Eustachian tube dysfunction. Interestingly chronic otomastoiditis is not found in non-human primates. Upright posture and enlarged skull have been postulated as potential predisposing factors.
Radiographic features
The term encompasses a number of conditions:
- tympanic membrane changes: thickening, retraction, tympanic membrane perforation or calcification (myringosclerosis)
- mastoid process changes: underdeveloped pneumatisation, sclerosis or opacification
- middle ear changes:
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