From the Guidelines
Treatment for mastoid effusion typically involves addressing the underlying cause, which is often related to middle ear infections or Eustachian tube dysfunction, and may require surgical intervention such as myringotomy with tympanostomy tube placement, as recommended by the clinical practice guideline for otitis media with effusion 1. The primary approach includes antibiotics and decongestants to improve Eustachian tube function.
- Antibiotics such as amoxicillin or amoxicillin-clavulanate may be prescribed to treat underlying infections.
- Decongestants like pseudoephedrine and nasal steroid sprays such as fluticasone may help improve Eustachian tube function. According to the guideline, tympanostomy tube insertion is the preferred initial procedure for surgical candidates, with adenoidectomy recommended for repeat surgery or when a distinct indication exists, such as adenoiditis or nasal obstruction 1. In more severe cases, a mastoidectomy might be required to remove infected tissue from the mastoid air cells.
- Patients should complete the full course of antibiotics even if symptoms improve quickly.
- Staying hydrated and using pain relievers like acetaminophen or ibuprofen as needed for discomfort is also recommended. Early treatment is crucial to prevent complications such as hearing loss, mastoiditis, or spread of infection to surrounding structures, as the mastoid air cells connect to the middle ear, so treating the effusion helps prevent more serious infections from developing in this area.
From the FDA Drug Label
Two hours after oral administration of a single 35 mg/kg dose of suspension of amoxicillin and clavulanate potassium to fasting children, average concentrations of 3 mcg/mL of amoxicillin and 0.5 mcg/mL of clavulanic acid were detected in middle ear effusions.
The treatment for mastoid effusion may involve the use of amoxicillin-clavulanate as it has been shown to achieve average concentrations of 3 mcg/mL of amoxicillin and 0.5 mcg/mL of clavulanic acid in middle ear effusions, which could be beneficial in treating the condition 2.
From the Research
Treatment for Mastoid Effusion
- The treatment for mastoid effusion is not directly addressed in the provided studies, but information on the treatment of related conditions such as acute mastoiditis and otitis media can be found.
- For acute mastoiditis, antibiotic treatment is often used, but the choice of antibiotic may depend on the causative organism 3, 4.
- In some cases, myringotomy may be performed to drain the middle ear and reduce the risk of complications 3.
- For otitis media with effusion, antibiotics, decongestants, and nasal steroids are not recommended as they do not hasten the clearance of middle ear fluid 5.
- Management of acute otitis media should begin with adequate analgesia, and antibiotic therapy can be deferred in children two years or older with mild symptoms 5.
- High-dose amoxicillin is the antibiotic of choice for treating acute otitis media in patients who are not allergic to penicillin 5.
Causative Organisms
- The causative organisms of acute mastoiditis include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus 3, 4.
- The distribution of causative organisms in acute mastoiditis differs from that in acute otitis media 3.
- In some cases, the purulent discharge may be sterilized by pre-operative antibiotic treatment, making it difficult to identify the causative organism 4.