Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.


Mastoiditis is an infection within the mastoid region of the temporal bone, which is located just behind the outer ear. The mastoid bone is an airy, honeycomb-like structure that communicates directly with the middle ear (space under the eardrum). Middle ear or ear canal infections can extend into the mastoid. If left untreated, the honeycomb-like bony structure of the mastoid may be destroyed, leading to “coalescence,” which is a fusing of the bony structure. Symptoms of mastoiditis include ear pain, post-auricular tenderness, ear drainage (if there is a tympanic membrane perforation or defect within the ear canal), headache, fever, hearing loss, and redness/swelling behind the ear. The primary cause of acute (short-term) mastoiditis is acute otitis media. Chronic (long-term) mastoiditis is generally associated with chronic suppurative otitis media or cholesteatoma.

Mastoiditis can be difficult to treat because oral and IV medications may not be able to reach deep enough into the mastoid bone to get to all of the infection. A CT scan will show the extent mastoid bone destruction or complications of mastoiditis. A small slit (myringotomy) may be made in the eardrum to help drain infected fluid if damage to the mastoid is minimal. If antibiotic treatment is not sufficient and complications arise (labyrinthitis, facial nerve paralysis, subperiosteal abscess, sigmoid sinus thrombosis, meningitis, or brain abscess), a surgical procedure called a mastoidectomy may be required.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care.
  • The surgical management of mastoiditis is technically challenging and should only be performed by those experienced in ear surgery. Dr. Jacob’s practice is limited to complex Otology/Neurotology; therefore, his background and extensive clinical experience of thousands of ear procedures makes him a clear choice for ear care in the Southwest. Ear & Hearing, in partnership with Tucson Medical Center, has assembled a comprehensive team of infectious disease specialists, intensive care physicians, audiologists, head & neck surgeons, neurologists, neurological surgeons, & physical therapists to provide total care to patients with mastoiditis and its complications.