Definition

What is Mastoidectomy?

A mastoidectomy is a surgical procedure that removes diseased mastoid air cells. The mastoid is the part of your skull located behind your ear. It’s filled with air cells made of bone and looks like a honey comb. The diseased cells are often the result of an ear infection that has spread into your skull. The procedure can also be used to remove an abnormal growth of the ear known as a cholesteatoma.

There are variations of mastoidectomy procedures, including:

Simple mastoidectomy, in which your surgeon opens your mastoid bone, removes the infected air cells, and drains your middle ear
Radical mastoidectomy, in which your surgeon may remove your mastoid air cells, your eardrum, most of your middle ear structures, and your ear canal. This procedure is reserved for complicated mastoid disease.
Modified radical mastoidectomy, which is a less severe form of radical mastoidectomy that involves removing mastoid air cells along with some, but not all, middle ear structures

The purpose of Mastoidectomy is to remove infected mastoid air cells resulting from ear infections, such as mastoiditis or chronic otitis, or by inflammatory disease of the middle ear (cholesteatoma).

When is Mastoidectomy needed?

A mastoidectomy can treat complications of chronic otitis media (COM). COM is an ongoing ear infection in your middle ear. A cholesteatoma, which is a skin cyst, can be a complication from these ongoing infections. The cyst grows gradually over time and may lead to serious complications such as:

Abscess in the brain
Deafness
Dizziness or vertigo
Damage to your facial nerve that causes facial paralysis
Meningitis, or inflammation of the membranes of your brain
Labyrinthitis, or inflammation of your inner ear
Ongoing ear drainage

Your doctor may also perform a mastoidectomy to put in a cochlear implant. This small, complex electronic device can help provide you with a sense of sound if you’re profoundly deaf or severely hard of hearing.

This surgery can also remove abnormal growths at the base of your skull.

Precautions

What should you know before undergoing Mastoidectomy?

Not everyone can safely undergo this procedure. Eligibility depends on many factors such as individual condition, medical history, and general health.

What are the complications and side effects?

After mastoidectomy, you may have a headache, discomfort, and some numbness.

Complications of a mastoidectomy can include:

Facial nerve paralysis or weakness, which is a rare complication caused by facial nerve injury
Sensorineural hearing loss, which is a type of inner ear hearing loss
Dizziness or vertigo, which may persist for several days
A change in taste that causes food to seem metallic, sour, or otherwise off, and often resolves after a few months
Tinnitus, which causes abnormal noises in your ear such as ringing, buzzing, and hissing

Call your doctor if you experience any of these symptoms. You should also call your doctor if you have heavy ear bleeding or discharge, a fever over 38°C, or if your wound is not healing properly.

It is important you understand the precautions and know the possible complication and side effects before having this Mastoidectomy. If you have any questions, please consult with your doctor or surgeon for more information.

Process

How do I prepare for Mastoidectomy?

You will be prepared for surgery by shaving the hair behind the ear on the mastoid bone. Mild soap and a water solution are commonly used to cleanse the outer ear and surrounding skin.

What happens during Mastoidectomy?

The procedure takes approximately two to three hours. Your doctor usually performs a mastoidectomy using general anesthesia. This ensures that you’re asleep and unable to feel pain. For a simple mastoidectomy, your surgeon will usually:

Access your mastoid bone through a cut made behind your ear.
Use a microscope and a small drill to open your mastoid bone.
Use suction irrigation to keep the surgical area free of bone dust.
Drill out the infected air cells.
Stitch up the operative site.
Cover the site with gauze to keep the wound clean and dry.

Your surgeon may also use a facial nerve monitor during surgery. This helps to limit injury to the facial nerve.

What happens after Mastoidectomy?

You can expect to have bandages over your ear when you wake up. There will also be stitches close to your ear.

After surgery, your doctor may:

Prescribe pain medication
Give you antibiotics to treat any infection
Ask you to schedule a return for wound check and removal of any bandages and stitches

If you have any questions or concerns, please consult with your doctor or surgeon for more information.

Recovery

What should you do after Mastoidectomy?

Follow your doctor’s specific instructions on caring for your wound, as well when you can swim or bathe. You should avoid all strenuous activity for at least two to four weeks afterward, depending on your surgery. Also refrain from putting pressure on your ear.