A hallmark sign of mastoiditis includes which manifestation?

• A. Fever and ear pain
• B. Swelling behind the ear
• C. Hearing loss
• D. Redness of the cheek

Answer: (B)

The main concept is recognizing postauricular swelling as the hallmark sign of mastoiditis. When the mastoid air cells become infected, the inflammation extends into the surrounding soft tissues behind the ear, producing a swollen, tender area just behind the auricle and often a visible fullness or protrusion of the ear. This postauricular swelling is what distinguishes mastoiditis from a simple otitis media, where you might see fever and ear pain but not this specific behind-the-ear edema.

Fever and ear pain can accompany many middle-ear infections, so they aren’t as specific. Hearing loss can occur if the infection affects the ossicles or inner ear, but it isn’t the defining feature. Redness of the cheek suggests other facial or sinus issues rather than the characteristic behind-the-ear involvement of mastoiditis.