Sclerotic mastoid decreases the surface area for gaseous exchange, causing pressure changes which may be the cause of the ear pathology..or middle ear pathology/recurrent infections cause the sclerosis of air cells.
I think that poor mastoid aeration leads to underdevelopment and sclerosis and may be why children with a higher rate of Eustachian tube dysfunction, such as in cleft palate, Down Syndrome, etc., have underdeveloped and more sclerotic mastoid spaces. This may also apply to sinus development, as children with cystic fibrosis and poor sinus aeration, for example, tend to develop sinuses with smaller volumes.
Austin S. Rose, MD
Mastoid pneumatisation starts after the baby is born. If baby has problems in ventilation of middle ear ventilation due to whatever is the cause such mastoid are poorly pneumatised and remains underdeveloped also. Well pneumatised mastoids have classical honeycomb appearence and have bone marrow in it which is prone for infection. If these mastoids gets infected the honeycomb pattern due to septae between the aircells gets demineralised due to hyperemia. In recovery phase redeposion of bone occurs and the mastoid now becomes sclerotic.
The long standing bad ventillation of the middle ear due to Eustachian tube dysfunction leads to mastoid under development and sclerosis.. a common operative finding in cholesteatoma surgery is the sclerotic small mastoid as poor ventillation is the cause of both.
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