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JAMA. 1935;104(26):2315-2319. doi:10.1001/jama.1935.02760260003002.
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The diagnosis of silent mastoiditis is often difficult because of the very mild systemic as well as local manifestations of the disease.

Silent mastoiditis may be defined as an insidious progressive destruction of the mastoid process with or without otorrhea. The disease is afebrile and painless in its course. The tympanic membrane is usually involved, the hearing may be slightly or considerably impaired, and a history of some middle ear infection is frequently obtained.

Occasionally the ear condition is discovered only after the appearance of systemic or intracranial complications. In infants postauricular swelling or subperiosteal abscess may often be the first indication of mastoid involvement.

The response to timely surgical intervention is usually satisfactory, but failure to recognize the condition may lead to serious consequences.

Silent mastoiditis has been discussed in otologic literature under various and confusing names. Thus, Amberg1 suggests dividing mastoid disease into three groups: mastoiditis acutissima,


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