Unraveling the Mystery behind Mastoiditis without Apparent Otitis Media

Chronic otitis media is the most common cause of mastoiditis. Rare causes of mastoiditis without apparent otitis media have to be ruled out in cases of atypical presentation and poor response to conventional treatment. To analyze unusual presentations of mastoiditis without apparent otitis media. Seven patients who came to ENT outpatient department (Otorhinolaryngology and Head and Neck Surgery OPD) with a history and clinical features, suggestive of mastoiditis without apparent otitis media were identified. After relevant audiological, radiological, and histopathological investigations, appropriate surgical exploration or management was done. Not applicable. Tuberculosis of the temporal bone, fungal mastoiditis, and osteomyelitis were some of the unusual causes of mastoiditis without apparent otitis media identified from the evaluation of the seven cases. Tegmen tympani defect and intracranial complications were also associated with a few cases. Mastoiditis usually presents as a result of acute or chronic otitis media. Unexplained hearing loss, pain behind the ear, and postauricular swelling without any history of persistent otorrhea have to be evaluated carefully. Rare causes of mastoiditis without apparent otitis media have to be ruled out in cases of atypical presentation and poor response to conventional treatment. Radiological investigations and histopathological examination go hand in hand in confirming the clinical diagnosis. Early surgical intervention treats the primary cause and prevents further intracranial complications.