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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Symptoms of acute mastoiditis include:

  • earache, persistent and throbbing
  • a creamy, often profuse ear discharge
  • a history of increasing deafness

Signs include:

  • patient is pyrexial and usually looks very ill
  • there may be marked tenderness over the mastoid antrum
  • the pinna may be pushed down and forward due to a swelling in the post-auricular region. Examination from behind may be required to assess this.
  • the tympanic membrane is either red and bulging or perforated - N.B. a normal tympanic membrane that is not perforated is not seen in acute mastoiditis.
  • signs of conductive deafness, e.g. Rinne negative; Weber's test shows that sound is heard loudest in the deafer ear.

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