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H70.9 Mastoiditis – Definition, Causes & Treatment
H70.9 is the ICD-10 diagnosis code for mastoiditis, unspecified. It refers to an inflammation of the mastoid bone behind the ear, typically occurring as a complication of a middle ear infection.
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H70.9 is the ICD-10 diagnosis code for mastoiditis, unspecified. It refers to an inflammation of the mastoid bone behind the ear, typically occurring as a complication of a middle ear infection.
Definition
H70.9 is a diagnosis code from the ICD-10 classification (International Classification of Diseases) representing mastoiditis, unspecified. This code is used when mastoiditis has been diagnosed but no further specification of the type (e.g., acute or chronic) is documented.
What Is the Mastoid?
The mastoid process is a bony projection of the temporal bone located just behind the ear. It consists of air-filled cavities called mastoid cells, which are directly connected to the middle ear. This anatomical connection allows bacteria to spread from a middle ear infection into the bone.
Causes
Mastoiditis most commonly develops as a complication of acute or chronic otitis media (middle ear infection). Bacteria spread from the middle ear into the mastoid cells, causing infection and inflammation of the bone.
- Common pathogens: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus
- Untreated or inadequately treated middle ear infections
- Immune deficiency or pre-existing ear conditions
- Rarely: cholesteatoma (abnormal skin growth in the middle ear)
Symptoms
Typical signs and symptoms of mastoiditis include:
- Pain and tenderness behind the ear
- Redness and swelling over the mastoid area
- Protruding ear due to swelling behind the auricle
- Fever and general malaise
- Ear discharge (otorrhea)
- Hearing loss or ear pain
Diagnosis
Mastoiditis is diagnosed through clinical examination and imaging:
- ENT examination: Otoscopy to inspect the ear canal and eardrum
- Computed tomography (CT) of the temporal bone: Gold standard for assessing the extent of infection and detecting complications
- Blood tests: Elevated CRP and white blood cell count indicate infection
- Microbiological swab: To identify the causative organism and determine antibiotic sensitivity
Treatment
Treatment of mastoiditis depends on the severity and form of the condition:
Conservative Treatment
- Antibiotics: Intravenous broad-spectrum antibiotics (e.g., amoxicillin-clavulanate, cephalosporins) are the first-line treatment
- Myringotomy: Incision of the eardrum to allow drainage of fluid
Surgical Treatment
- Mastoidectomy: Surgical removal of infected mastoid cells in severe cases or when complications arise
- Insertion of a tympanostomy tube for ongoing drainage
Possible Complications
If left untreated, mastoiditis can lead to serious complications:
- Subperiosteal abscess (collection of pus beneath the periosteum)
- Meningitis (inflammation of the brain membranes)
- Brain abscess
- Sinus thrombosis (clotting in a cranial venous sinus)
- Permanent hearing loss
References
- World Health Organization (WHO): International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), 2019.
- Tarantino V, et al.: Acute mastoiditis in children – a 10-year retrospective study. International Journal of Pediatric Otorhinolaryngology, 2002.
- Leskinen K, Jero J: Acute complications of otitis media in adults. Clinical Otolaryngology, 2005.
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