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By Dr Alankrita Bansal
Consultant ENT- Head And Neck Surgery
What is Mastoidectomy Procedure Benefits and risks Care at Medicover Hospitals Frequently Asked Questions

What is Mastoidectomy

Mastoidectomy is a surgical procedure that removes the mastoid bone's air cells. The mastoid bone is a hard, bony bump located behind the ear. This bone contains honey-comb-like structures that are filled with air spaces called mastoid cells. It also connects air spaces of the middle part of the ear. Hence when a person has an ear disease that affects the middle ear, it can spread to the mastoid bone. In such a situation, mastoidectomy is necessary.

The cholesteatoma is usually removed during surgery. Cholesteatoma is abnormal skin growth behind the eardrum that can push into the middle ear or grow back to the mastoid bone. This causes the wearing of the mastoid bone and may result in hearing loss. With this help, the eardrum can be repaired, and the hearing mechanism can be reconstructed.

Indications:

  • Eradication of Disease and Infection
  • Approach for Removal of Cholesteatoma
  • Establish Aeration
  • Restore Hearing

Procedure

Before the Procedure

  • The patient should bring the hospital file before the surgery, including all required test reports such as the major surgical profile, audiological evaluation reports, pre- anesthetic report, radiological investigation films and reports like CT scan which is the Gold Standard for aerols and MRI for Soft Tissue Lesions , any other investigations advised by your ENT surgeon.
  • The patient should not eat anything from midnight onwards before the surgery day.
  • The patient must shampoo their hair before the surgery day.
  • Keep the ear dry before the surgery. If you have an infection in the ear, the doctor will prescribe antibiotic ear drops for two weeks before the surgery.
  • You are asked to stop thinning blood medication such as aspirin two weeks before the surgery.

During the Procedure

  • The mastoidectomy is performed while the patient is completely unconscious i.e, under general anesthesia.
  • An incision (surgical cut) is made behind the ear. A surgical drill is used to open the mastoid bone. Following that, the infection or growth is removed.
  • Stitches are used to close the incision. A drainage tube may also be placed to drain the fluid.
  • Mastoidectomies of various degrees can be performed depending on the amount of infection or cholesteatoma present.
  • A simple mastoidectomy involves the surgeon opening the bone and removing any infection. A tube may be inserted through the eardrum to drain any pus or secretions from the middle ear. Antibiotics are then administered intravenously (via a vein) or orally.
  • A radical mastoidectomy removes most of the bone and is recommended when a cholesteatoma has spread widely. The eardrum and structures of the middle ear may be removed entirely. If possible, the stapes are spared to help preserve some hearing.
  • A modified radical mastoidectomy involves the preservation of some middle ear bones and the reconstruction of the eardrum (Tympanoplasty). Hearing impairment is common following both a modified radical and a radical mastoidectomy.

After the Procedure

  • During the first few weeks, your ear may be painful, tender, and numb. Pain relievers should be taken as directed.
  • Due to the presence of a pack, blood, and a dissolvable sponge in your ear, it is common for your ear to feel blocked. The pack placed in the ear and stitches will be removed one to two weeks after the surgery.
  • You should use ear drops for a period of time following the procedure. It is recommended that you apply the drops to the pack at first. Once the pack is removed, you will continue to use the drops until instructed to stop.
  • In your ear, you will also hear crackling and noises. It is not recommended to scratch the ear when it itches.
  • The blood and dissolvable sponge in the ear take longer to disappear, and it could take up to three months to observe an improvement in your hearing.
  • For the first few days, there may be some blood stained discharge from the ear or wound. You can soak this with a cotton ball in your ear.
  • You may feel dizzy for a while after the procedure. Because the taste nerve runs beneath the eardrum and can be stretched during the operation, some people may experience a change in taste sensation.
  • In the first few weeks after surgery, you could use cotton wool and Vaseline to protect your ear and wound while washing your hair.
  • For the surgery, avoid blowing your nose or sniffing. To avoid ear pressure, sneeze with your mouth open.
  • Exercising, heavy lifting , and air travel should be avoided for four weeks following surgery.

Benefits

The benefits may include:

  • Removal of infection and preventing its spread.
  • Prevention of discharge from the ear.
  • Improvement in hearing.

Risks

Risks may include:

  • Changes in taste
  • Dizziness
  • Hearing loss
  • Infection that persists or keeps returning
  • Noises in the ear(tinnitus)
  • Weakness of the face
  • Cerebrospinal fluid leak
  • Damage to facial nerves or nerves that control the sense of taste

Care at Medicover

The Department of ENT at Medicover Hospital treats a wide range of ear, nose, and throat conditions in both adults and children. Our ENT department is comprised of qualified and trained ENT surgeons, head and neck surgeons with vast experience in all aspects of otolaryngology. The department has a track record of successfully completing some of the most complex procedures.

Citations

https://www.mountsinai.org/health-library/surgery/mastoidectomy
https://www.ncbi.nlm.nih.gov/books/NBK559153/
https://mountnittany.org/wellness-article/mastoidectomy

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Frequently Asked Questions

1. What is Mastoidectomy?

Mastoidectomy is a surgical procedure that removes a portion of the bone behind the ear known as the Mastoid. The tiny and porous honeycomb-like structure located behind the ear is known as the mastoid bone. This procedure aids in the treatment of mastoiditis, cholesteatoma, and is sometimes used in conjunction with other procedures to gain access to the middle ear.

2. What are the complications of a mastoidectomy?

Complications of a mastoidectomy include facial nerve paralysis or weakness, sensorineural hearing loss, dizziness or vertigo.

3. What is the purpose of the mastoid?

The mastoid bone, which contains air cells, is a component of the temporal bone of the skull. Mastoid air cells are thought to protect delicate ear structures, regulate ear pressure, and possibly protect the temporal bone during trauma.

4. How painful is mastoidectomy surgery?

The incision or cut is made behind the ear and becomes sore after surgery. This could cause ear pain for about a week. You may also experience a blocked or stuffy feeling in your ear for some time.

5. Can I fly after mastoidectomy?

Flying should be avoided for 6 weeks following surgery. Changes in air pressure may have an adverse effect on your recovery.

6. Who is at risk for mastoiditis?

A middle ear infection which is not treated with antibiotics, a weakened immune system, and cholesteatoma in the middle ear are the most common risk factors for mastoiditis.

7. What is silent mastoiditis?

Silent mastoiditis is defined as the gradual destruction of the mastoid process with or without otorrhea. In its early stages, the disease is afebrile and painless.

8. How can mastoiditis be prevented?

Mastoiditis can be avoided by treating all ear infections effectively. If you develop an ear infection, seek immediate medical attention and follow your doctor's instructions. This could include taking antibiotics orally for 7 to 10 days.

9. Can an ear infection spread to the brain?

In rare cases, severe middle ear infections spread to other tissues in the skull, such as the brain or the membranes covering the brain (Meningitis).

10. What are the long-term results of Mastoidectomy?

Mastoidectomy provides relief from recurrent infections of the ear and improved hearing.

11. What are the options if Mastoidectomy fails?

If the Mastoidectomy fails, the doctor may recommend revision surgery or open surgery.