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Dr. M: See, I told you I'd be back :) just have been doing alot of thinking!
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yanksgirl posted:
How can a diagnosis of 'acute mastoiditis' not be a serious thing?
I know you said in years past it was due to not having the 'right anti-biotics', but now we do.
The secretary at my Internists office was the one reading me the 'report' the doctor had told her to 'fax' to my Ent doctor.
She said the 'diagnosis is 'acute mastoiditis'! I know things are minor, moderate and acute! If it would have said a minor or moderate inflammation, I might have understood the 'no anti-biotic' answer or the answer of 'not to worry'! But I've been researching it--yes, on WebMD and other sites and 'acute' anything is not to be ignored. My ent's nurse said, after looking over the MRI results, he concluded it was nothing to be concerned about--just part of the healing of the surgery and my ongoing Meniere's problems and 'not to worry'!
I even thought about calling my primary to see if he agrees with that but figure he'll say--'I'm no the Ent specialist' so he won't go against or question his diagnosis. If you were presented with a patient post op like I am with the same symptoms, would that MRI results cause you to prescribe an antibiotic or to question it more? Not sure who I'd question as I've already done that with my ent. And yes, I trust him, but with still having the head pressure and etc., it sure causes me to wonder. I have 'no pain'--have had occasional sharp shooting like pains that only lasted about 3 seconds if that long---but only happened a few times awhile back. No drainage, no fever, just this awful head pressure.
So, just wondering as always and thought I'd ask you--once again your thoughts on all of this. Thanks. yanksgirl
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Rod Moser, PA, PhD responded:
The radiologist called it acute sinusitis based on what he saw on the MRI, however, he does not know you, your case, and he did not examine you. Any diagnosis most be correlated with clinical findings, so only your ENT can determine the significance of that finding. It may not be acute mastoiditis at all, so hang in there.

Acute mastoiditis tends to (
 
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Rod Moser, PA, PhD replied to Rod Moser, PA, PhD's response:
I hate not having my own compter! Sorry it posted in mid-sentence...

As I was saying, acute mastoiditis tends to have a sore mastoid (the area behind the ear) and it can be red and swollen. I am guessing, but I bet you don't have those things....
 
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yanksgirl replied to Rod Moser, PA, PhD's response:
Well I think you meant in your first sentence to say 'acute mastoiditis'--not sinusitis--since that wasn't part of the report, but what you say makes sense in your next message (after your computer gave you problems).
The ear I had surgery on is sore when I wash behind it in the shower and then dry it--very tender to the touch, even after 4 1/2 mos. No swelling or pain otherwise though. So, what you said about any diagnosis must be corelated with clinical findings, makes sense.
I won't worry about that part anymore unless other symptoms other than the head pressure occur. The word 'acute' rather than a 'mild inflamation' or something like that was what really got me! Thanks for your input. yanksgirl
 
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Rod Moser, PA, PhD replied to yanksgirl's response:
Yep...too many "itis" in my mind. I did mean mastoiditis. If you are having pain and tenderness in this area, it could be an accurate diagnosis that will require some sort of individual treatment....from a few weeks of antibiotics or surgery. I doubt that you will need surgery, however, but that is only based on what you have told me.

So when is your doctor going to comment????
 
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rohvannyn replied to Rod Moser, PA, PhD's response:
Miniquestion for you: Doesn't "acute" just mean brief in duration but somewhat intense? Or am I way off? Thanks in advance. I continue to love your blog.
 
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yanksgirl replied to rohvannyn's response:
I don't think 'acute' necessarily means 'brief! One can have an acute attack that last for hours or days of most anything--or it can mean 'a very serious--whatever'!
I could be wrong too--I'm sure Dr. M will set us straight on this.
yanksgirl
 
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yanksgirl replied to Rod Moser, PA, PhD's response:
He already did---2 times. I called the office and his nurse called and said he had looked at the MRI report and said this was 'normal' following my surgery.

When I said 'let me tell you what the MRI tech told me when he was doing the MRI--he first said it would take only 20 mins. then he'd do the dye injection and add another 5 mins. or so.
He pulled me out in 20 mins. said the Radiologist said the order was a bit 'unclear' so he wanted me in again for a 'deeper look into the ear' and it was another 24 mins. then the dye injection and another 14 or so minutes.
I explained this to his nurse and she said, 'I'm writing all this down', then called back--3 hours later and said he still says this is nothing that needs antibiotic treatment, but is just part of the surgery still healing and will take time and 'not to worry'!
Easy for them to say!
 
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Rod Moser, PA, PhD replied to yanksgirl's response:
I hope you understand the explanation, but personally, I think it would be good to hear it from your ENT first-hand, not filtered through his nurse. Again, some things "look" like acute mastoiditis, but do not really need the same managment as a true mastoiditis. This is your doctor's call. I can't see that MRI (not the report, but the actual images) to render a patient-specific comment.
 
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Rod Moser, PA, PhD replied to rohvannyn's response:
Short duration....not necessarily INTENSE. Thanks for reading and commenting on the blogs.
 
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yanksgirl replied to Rod Moser, PA, PhD's response:
Thanks Dr. M: Sorry I answered--but didn't realize the question was directed at you but was a comment on mine, until after I'd posted it.
We got the answer we were looking for==as always! Thanks again.
 
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Rod Moser, PA, PhD replied to yanksgirl's response:
You are welcome. I will be at my home office again in about 5 days.....


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