The infrequent occurrence of mastoiditis without apparent otitis media has prompted the following report of two cases. They are indeed interesting, and I hope that by adding to those already reported there may be a better understanding of this unusual type of infection.
ETIOLOGY AND SYMPTOMS
The term primary mastoiditis, as it has been used to designate this type of infection, is misleading, since it implies an involvement primarily in the mastoid and not secondary to an infection that has passed through the eustachian tube and middle ear. It is generally agreed that the infection enters the mastoid by this route. Involvement of the middle ear may produce no symptoms or signs. The infection spreads to the mastoid through the aditus ad antrum, and if this passage is small, it becomes occluded. The infection in the middle ear subsides because of drainage through the eustachian tube, and that in
HANSEL FK. MASTOIDITIS WITHOUT APPARENT OTITIS MEDIA. Arch Otolaryngol. 1926;3(5):433–437. doi:10.1001/archotol.1926.00580010463004
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