A subcutaneous bursa over the mastoid process, developing from repetitive pressure between the skull and hard surfaces (pillows, headwear). It presents as a posterior auricular swelling that may be confused with mastoiditis or parotid tail swelling.
Mastoid process bursitis is distinguished from mastoiditis by the absence of fever, the normal ear, and the absence of post-auricular skin erythema with the characteristic crease obliteration of mastoiditis. Post-auricular lymph node enlargement in the same region requires fine-needle aspiration to distinguish.
Painless fluctuant swelling over the mastoid process from pressure bursa, distinguished from mastoiditis by clinical examination and normal tympanic membrane.
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