Mastoidectomy Surgery: Indications, Procedure, Benefits, Risks, and Recovery

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In case of recurring ear infections or complications, mastoidectomy surgery can be the best course of treatment.

 

Mastoidectomy Surgery Overview

A mastoidectomy surgery is a procedure that is used to remove diseased cells from the hollow, air-filled spaces within the mastoid portion of the temporal bone. The mastoid is a honeycomb-shaped sponge-like bone structure located as a part of the skull behind the ear.

Mastoidectomy surgery removes the diseased air cells caused by an ear infection that has spread to the skull. The surgery can also be used to remove abnormal growth of the ear, known as cholesteatoma.

Mastoidectomy Indications

A mastoidectomy surgery is performed to treat complications where an ongoing ear infection in the middle ear or chronic otitis media (COM) spreads to the skull. 

The surgery can also be performed in the following cases:

To treat cholesteatoma:

Cholesteatoma is a noncancerous growth that can occur behind your eardrum because of a chronic middle ear infection. Mastoidectomy surgery can be used to treat cholesteatoma in patients.

A cholesteatoma, if left untreated, can gradually grow over time, causing complications like:

  • Deafness
  • Dizziness or vertigo
  • An abscess in the brain
  • Ongoing ear drainage
  • Meningitis or inflammation of the membranes in the brain
  • Labyrinthitis or inflammation in the inner ear

To repair the eardrum:

Where you have a ruptured eardrum, mastoidectomy surgery can be performed with tympanoplasty to repair the eardrum.

Tympanoplasty is a procedure performed to repair a ruptured eardrum, although it can also be performed behind the eardrum even when it does not require repair. 

In cochlear implants:

Doctors may perform mastoidectomy surgery while putting in a cochlear implant. Cochlear implants are tiny electronic devices that help you experience a sense of sound if you are deaf or severely hard of hearing.

In abnormal skull growth:

Mastoidectomy surgery can also treat abnormal growth at the base of your skull bone.

 

The Mastoidectomy Procedure

The mastoidectomy surgery can be of three types:

  • Simple mastoidectomy: It involves a simple procedure where the surgeon opens the mastoid bone, removes the diseased cells, and drains your middle ear.
  • Modified radical mastoidectomy: The procedure involves the removal of a part of the middle ear structure with the diseased mastoid cells.
  • Radical mastoidectomy: The procedure is used in complicated mastoid diseases. The surgeon may remove the diseased mastoid air cells with most of the middle ear structure, the eardrum, and the ear canal.

The nature of the surgery will depend on the disease and your unique situation. You can suffer from hearing loss following radical and modified radical mastoidectomy procedures.


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The mastoidectomy procedure

The mastoidectomy surgery is performed in an operating room by a physician specializing in ear, nose, and throat disorders using an operating microscope. Patients will be given general anesthesia by an anesthesiologist. Typically, patients should plan to go home the same day. 

 In the case of a simple mastoidectomy surgery, your surgeon will:

  • Access your mastoid bone by creating a carefully made incision behind your ear. Care should be taken to cause minimal scarring in the incision area.
  • Use a microscope and other specialized instruments to open the mastoid bone.
  • Keep the area free of bone dust using the suction irrigation method.
  • Remove the infected air cells from within the mastoid bone.
  • Stitch up the surgical site.
  • Dress the surgical wound in gauze to keep it clean and dry.

Your surgeon may use a facial nerve monitor during the procedure to limit facial nerve injury.

A simple mastoidectomy surgery typically takes 2-3 hours to complete

 

Benefits of Mastoidectomy Surgery

The mastoidectomy surgery can treat chronic and recurrent ear infections. It can also prevent serious complications from cholesteatoma like:

  • Hearing loss
  • Vertigo and dizziness
  • Meningitis
  • Labyrinthitis
  • Facial weakness 
  • Brain abscess

 

Risks of Mastoidectomy Surgery

The risks of mastoidectomy surgery include:

  • Bleeding
  • Dizziness
  • Numbness around the auricle (ear)
  • Change in appearance of the ear
  • Loss of hearing in the inner ear (sensorineural hearing loss)
  • Recurrent infection in the surgery area
  • Noises in the ear that involve ringing, hissing, and buzzing (tinnitus)
  • Cerebrospinal fluid leak
  • Voice changes because of the effect of anesthesia
  • A change in taste where food tastes sour, metallic, or odd. It usually resolves after a few months
  • Weakness in the face, including facial nerve paralysis or injury to nerves that control facial movement
  • Difficulty in swallowing and breathing
  • Complications that can result from anesthesia

Prepare to discuss all possible risk factors with your surgeon and get all your questions answered before surgery.

 

Recovery

Usually, it takes 3 to 7 days to make a complete recovery after the surgery. Some patients do get better in a few days, while others may take up to 14 days to make a full recovery.

 

You can find stitches near your ear after waking up and can suffer experience headaches, numbness, and discomfort. Pain can occur for the first few days after surgery. Full healing typically takes 8-12 weeks. Activity restrictions may last up to 3-4 weeks. Ask your surgeon for more details.

 

Managing symptoms

 

Post-surgery ear symptoms:

After the surgery, you can experience the following symptoms:

  • Fullness and dampened hearing
  • Popping, crackling, or clicking sounds
  • Thin bloody drainage lasting for a few days
  • Mild pain and discomfort in the area
  • Outward protrusion of the ear

Where an incision is made behind the ear, the sutures used to close the site would eventually dissolve.

 

Safeguards after surgery

After surgery, make sure not to swim or allow water to enter the ear for four weeks after the operation. Place a cotton ball soaked in petroleum jelly every time you shower to prevent infection from the water.

Avoid blowing your nose till after your post-operative doctor visit. Use saline water or nasal mist spray to treat nasal blockages or congestion.

In addition, you must avoid all forms of strenuous activities for at least 2 to 4 weeks following the surgery. Also, avoid putting pressure on your ear.

Your voice might sound different because of the after-effects of anesthesia. You must inform your doctor if the voice change does not resolve in one week following the procedure.

 

MASTOIDECTOMY RECOVERY TIME

The timeframe for a full recovery after tympanoplasty will vary from one person to the next. Most children and adult patients should plan to go home once recovered from anesthesia on the same day.

You will see your ENT for a one-week follow-up appointment to determine how well you are healing, to make sure there is no infection, and to remove the stitches placed during surgery. If there are no complications, you may be released to return to school or work during this appointment, but it is important to closely follow aftercare instructions as it can take up to 3 months for total healing.

Once the internal packing material has had time to dissolve, a hearing test will be conducted to determine how well your hearing has improved. This is often scheduled between 8 to 12 weeks after surgery, depending on how the ear is healed. The most important thing to remember is to avoid swimming or air travel until specifically released to do so.

 

When to call the doctor?

After the mastoidectomy procedure, you need to call your doctor promptly if you have:

  • A fever of 100.5 degrees F or higher
  • Facial weakness
  • Dizziness or vertigo
  • Heavy ear bleeding or discharge
  • Loss of hearing

 

Mastoidectomy Surgery at Houston ENT & Allergy

If chronic ear infections affect your everyday life, we can help you.

We at Houston ENT & Allergy have served the greater Houston community for over 100 years. Our specialists are board-certified physicians passionate about diagnosing, treating, and educating people to prevent ENT conditions like recurrent ear infections, helping them lead an everyday life.

If you are currently suffering from recurrent ear infections, hearing problems, or other ENT-related symptoms, schedule an appointment today.


 

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