A mastoidectomy is a procedure for removing diseased mastoid air cells. The mastoid is part of your skull, located behind your ear. It’s filled with air cells which are made of bone and resemble a honeycomb. The diseased cells are generally caused by an ear infection that has spread into the skull.
The procedure is also used for removing an abnormal growth of the ear, a condition known as cholesteatoma. This surgery is not very common today, as antibiotics are used for treating infections. However, when antibiotics fail to provide results, surgery is an option.
A mastoidectomy is generally performed for treating complications of chronic otitis media, a type of ear infection. These infections can lead to a complication of cholesteatoma, a skin cyst. This cyst can grow over time and lead to various other serious complications, which can include:
- Abscess in the brian
- Ongoing ear drainage
- Damage to the facial nerve which can lead to facial paralysis
A mastoidectomy can also be performed to put in a cochlear implant, a small, complex electronic device which can provide you with a sense of sound if you are profoundly deaf or severely hard of hearing.
This surgery can also remove abnormal growths at the base of the skull.
Mastoidectomy is generally of various types, the main variations include:
- Simple Mastoidectomy- In this procedure, your surgeon opens your mastoid bone and removes all the air cells that are infected. Then he/she drains your middle ear.
- Radical mastoidectomy- In this procedure, the surgeon may remove your mastoid air cells, your eardrum, most of your middle ear structures as well as your ear canal. This procedure is generally considered when the mastoid disease is complicated.
- Modified radical mastoidectomy- This is a less severe form of radical mastoidectomy and it involves removing mastoid air cells along with only a few parts of the middle ear structures.
If you undergo radical or modified radical mastoidectomy, then you will most likely suffer from hearing loss.
The procedure is generally performed using general anesthesia and therefore you will be asleep and unable to feel pain during the procedure.
Generally, the procedure consists of the following steps:
First, the surgeon first makes a cut behind your ear, to access your mastoid bone. Then he/she uses a microscope and a small drill to open the mastoid bone. With the help of suction irrigation, he/she keeps the surgical area free of bone dust. Then the infected air cells are drilled out.
Once this is done, the surgeon will stitch the operated site, and cover it with gauze to keep the wound clean and dry.
During the surgery, your surgeon might be using a facial nerve monitor to help limit any injury to your facial nerve.
You might experience numbness, discomfort as well as a headache after you regain consciousness. There will be bandages over your ear and stitches close to it.
Your doctor might prescribe you pain medication, antibiotics for treating any infection and ask you to schedule another appointment so that he/she can check the wounds and remove any bandages and stitches.
Your doctor should provide specific instructions regarding caring for your wound as well as when you are able to swim or bathe. Make sure you avoid all kinds of strenuous activity for at least two to four weeks afterward. Also, avoid putting too much pressure on your ear.
Risks and complications
Complications associated with mastoidectomy include:
- Facial nerve weakness or paralysis, a rare complication caused by facial nerve injury
- dizziness or vertigo, which can continue for many days
- sensorineural hearing loss, a type of inner ear hearing loss
- A change in taste that causes food to seem sour, metallic, or even off. This should resolve within some time.
- tinnitus, a condition where you might hear abnormal noises in your ears such as ringing, hissing or buzzing
Inform your doctor immediately if you experience any of these symptoms. If you have heavy ear bleeding or discharge or a fever over 38°C, or if the wound is not healing properly as it should, then you should inform your doctor as well.
Before you undergo the procedure, it is important to remember that hearing loss is common with modified radical and radical mastoidectomy.