Brief Answer: chronic mastoiditis with petrous apicitis Detailed Answer: Hi XXXXXXX in my opinion you are suffering from chronic infection of the mastoid bone. Initially you had a middle ear infection where there was pus behind the ear drum which has spread to mastoid bone causing chronic infection. Haemorrahgic otitis media is usually caused by bete haemolytic streptococcus bacteria, second being pneomococcus, and pseudomonas bacteria Antibiotics is usually decided based on culture report, but your culture shows no organism, so antibiotics which will cover all the bacteria will be given. Your 3 rd mastoidectomy report says there is chronic infection of mastoid bone also chronic infection of tip of petrous bone , that is called petrous apicitis. Mastoid is a part of petrous bone which gets infected first, then the infection spreads to apex. Because of chronic infection there is granulation tissue grown in the petrous apex and also some collected pus in the petrous apex region. Thia was cleared in the 3 rd mastoidectomy, so there are less chances of recurrences of infection. Histopathology report shows some chronic inflammatory changes, but not specific for any particular disease or infection. There is no active infection now so not to worry. Treatment will be now with antibiotics since the doctor has cleared the petrous apex there are less chances of recurrences. Dont worry you will be fine

---

Brief Answer: piperacillin with sulbactum, good surgical treatment. Detailed Answer: Hi XXXXXXX in my opinion, amikacin is a good antibiotic commonly given in ear infection. Other antibiotics are piperacillin with sulbactum combination. In 3 rd mastoidectomy they have gone from mastoid bone upto the petrous apex or petrous tip. This petrous tip is part of temporal bone which is present in centre of your skull.any ear infection can easily spred till centre of your skull through the bone. Suspecting that the infection has spread till there they have opened the petrous apex bone and there they have found that there was collected pus and some granulation tissue. They drained the pus and cleared the granulation. This was the foci of infection which was not cleared in prevous surgeries. That is the reason your problem kept recurring. Now it cleared as per your surgeon explanation. Your pain will go gradually, but how much your mastoid cavities are healed , how ia your wound now, we cant tell it without seeing. Mastoid cavity takes atleast 4 to 6 weeks to heal, or even more if it is major surgery like yours is. So keep in touch with your doctor, continus treatment and have faith in them. In my opinion, you will be fine after a week.dont worry.

---

Brief Answer: hi XXXXXXX sorry for delayed reply. Detailed Answer: Hi XXXXXXX cortical mastoidectomy is done for chronic infection of mastoid cavity with middle ear infection. In cortical mastoidectomy the middle ear, aditus, mastoid cavity extending upto petrous apex is cleared off the infections, pus, granulation tissue, etc. While doing cortical mastoidectomy if the aditus is blocked by granulation tissue then , The granulation tissue is removed and aditus is made patent. The aditus is made patent at time of surgery only. blood clots in middle ear after surgery are self resolving, they take atleast 4 to 6 weeks to resolve it. There is no treatment if it doesn't get resolved. If blood is pooled in middle ear causing hematoma not resolving then we operate and remove it. Mastoid cavity and middle needs to be cleaned periodically twice a week upto 4 weeks regularly to prevent infection. If it is self cleaning, that's good. We won't meddle with it. Modified radical mastoidectomy is done if there a cholesteatoma / skin sac in the attic. Its a different disease and different procedure. Not related to your disease. Continue with amikacin, gentamycin, can also be tried.

---