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inflammation of the mastoid cells of the temporal bone, affecting the mucous membrane and bony tissue. Most ofter mastoiditis is a complication of a purulent inflammation of the middle ear. Primary mastoiditis arises as a result of trauma to the mastoid process or when infection from sepsis, syphilis, or tuberculosis penetrates by hematogenic means. Symptoms include sharp pain when pressure is applied to the anterosuperior part of the process or to its apex, reddening of the skin, swelling, flabbiness, and protrusion of the auricles forward and downward. In children the temperature rises to 39°-40°C; in adults it often remains normal. Treatment consists of administering antibiotics. If there is prolonged suppuration from the ear (three or four weeks) or at the first signs that infection has spread to the labyrinth and the meninges, treatment is surgical.