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Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear. Specifically, it is an inflammation of the mucosal lining of the mastoid antrum and mastoid air cell system inside [1] the mastoid process. The mastoid process is the portion of the temporal bone of the skull that is behind the ear.
The cells receive arterial supply from the stylomastoid branch of the occipital artery or posterior auricular artery, and (sometimes) a mastoid branch of the occipital artery. [1]: 749 The superior petrosal sinus receives venous drainage from the mastoid air cells (mastoid infection may thus lead to a cerebellar abscess). [2]: 443
The mastoid process is located posterior and inferior to the ear canal, lateral to the styloid process, and appears as a conical or pyramidal projection. It forms a bony prominence behind and below the ear. [1] It has variable size and form (e.g. it is larger in the male than in the female). It is also filled with sinuses, or mastoid cells.
The tympanic nerve (Jacobson's nerve) is a branch of the glossopharyngeal nerve passing through the petrous part of the temporal bone to reach the middle ear. It provides sensory innervation for the middle ear, the Eustachian tube, the parotid gland, and mastoid cells. It also carries parasympathetic fibers destined for the parotid gland.
Otitis media with effusion (OME), also known as serous otitis media (SOM) or secretory otitis media (SOM), and colloquially referred to as 'glue ear', [27] is fluid accumulation that can occur in the middle ear and mastoid air cells due to negative pressure produced by dysfunction of the Eustachian tube.
The mastoid lymph nodes (retroauricular lymph nodes or posterior auricular glands) are a small group of lymph nodes, usually two in number, located just beneath the ear, on the mastoid insertion of the sternocleidomastoideus muscle, beneath the posterior auricular muscle.
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The formation of a mastoid cavity by removal of the canal wall is the simplest and most effective procedure for facilitating the removal of cholesteatoma, but may bestow the most lasting infirmity due to loss of ear function upon the patient treated in this way. The following strategies are employed to mitigate the effects of canal wall removal: