Brief Answer:
Consult an ENT Specialist and start treatment.

Detailed Answer:
Hi,

Thank you for your query.

1. From your report you seem to have a mild mastoiditis on the right side and a sclerotic mastoid on the right. Upload a few CT images for a better assessment.

2. This may be the source of mastoid tenderness and pain if other causes are ruled out.

3. Assuming that the eardrum examination is within normal limits, oral antibiotics, anti inflammatory medication, decongestants and steam inhalation should settle this minimal mastoid tip collection.

4. The mastoid bone is a large section of skull bone behind the ear which normally contains air cells which are connected to the middle ear and from there to the nose through the Eustachian Tube. The exact function of the mastoid is unknown, hence various theories exist. However it is known that mastoiditis is associated with ear problems.

5. Sclerosis is a common and very long term event where fewer air cells develop over the years. This cannot be altered or treated. There must be a chronic mastoiditis on the left side as well since the pain is on the left side.

6. Chronic mastoiditis on the other hand can be treated to relieve the pain, sometimes with intravenous medication if it persists. This is because bone has very poor blood supply and medication does not reach deep into bones in sufficient concentration when taken orally.

7. Hence consult an ENT Specialist and start treatment.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

---

Brief Answer:
You have a mild problem, which is why the pain is intermittent.

Detailed Answer:
Hi,

Thank you for writing back.

1. Bone itself does not feel pain, the linings of the bone are sensitive.

2. The pain is intermittent as the inflammation is increasing and subsiding. In a way it is a good sign as it shows that the mastoiditis settles down and is capable of healing with medication.

3. Whenever the mastoid drains out via the middle ear and nose, the pain subsides.

4. Let an ENT Specialist check the tenderness of the mastoid bone and examine the ear drum. Tenderness on pressure is usually checked where the bone is thinnest. this would roughly correspond to the cymba conchae of the auricle (pinna) and the mastoid tip in a well pneumatised mastoid.

5. The tenderness is a sign that some infection or inflammation exists in that region.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

---