The mastoid is a sponge-like, honeycomb-shaped part of the skull, just behind the ear. A Mastoidectomy is a surgical procedure where diseased cells are removed from the air-filled spaces in the mastoid bone. It is done to treat cholesteatoma or ear infections that spread into the skull. It is also performed during cochlear implantation surgery.
Why do I need a Mastoidectomy?
A mastoidectomy is needed when an ear infection (otitis media) spreads into the skull. It is also performed to treat cholesteatoma. Cholesteatoma is a non-cancerous growth that forms behind the eardrum. It is usually a complication of chronic ear infections. Mastoidectomy is also performed as a part of cochlear implant surgery.
How serious is a mastoidectomy?
The extensiveness of the disease varies in each case.
A simple mastoidectomy treats the disease in the mastoid while leaving the ear canal and middle ear intact.
A Canal-Wall-Up Mastoidectomy or Tympanomastoidectomy is performed when more bone is to be removed than compared to a simple mastoidectomy. It is done to gain access to the middle ear space behind the eardrum, including the ossicles (three small bones inside the middle ear that help transmit sound waves).
A Canal-Wall-Down Mastoidectomy or Tympanomastoidectomy is performed when the disease has affected the ear canal beyond repair or when the removal of the ear canal is needed for the complete removal of the disease. It combines the ear canal and mastoid bone into one single large opening, called a Mastoid Cavity. Usually, the ear canal opening is widened to allow the mastoid cavity to be easily cleaned.
What happens during a Mastoidectomy surgery?
The surgery is performed while the patient is under general anaesthesia. This ensures the patient’s comfort during the surgical procedure. The surgeon will then make an incision behind the ear. The incision is made in such a way as to minimize post-operative scarring. The mastoid bone is then drilled to gain access to the air cells and the diseased air cells are removed. The wound is then closed with sutures and is wrapped in a mastoid bandage. The entire surgery takes around two to three hours.
What happens after a Mastoidectomy surgery?
Just like with any other procedure, the patient may experience mild discomfort after the procedure. The incision made behind the ear may be sore, and the ear may feel stuffy or full. To manage the discomfort, the patient will be prescribed medication.
The patient is kept in the hospital for monitoring for a day, and if there are no issues, is discharged the next day. Post-operative guidelines will be given to the patient on discharge, which must be followed closely.
What are the risks of a Mastoidectomy surgery?
As with any surgery, there are certain risks or complications. These may include:
- Change in taste which could last a few months.
- Tinnitus (Ringing in the ear)
- Inner ear hearing loss (Sensorineural hearing loss)
- Facial nerve injury could cause facial weakness or paralysis.
However, special care is taken to ensure patients do not face similar issues during surgery.
What is the outlook of patients who undergo Mastoidectomy surgery?
Mastoidectomy is largely successful, however, the outlook depends on the reason for the surgery and the type of mastoidectomy performed. The main aim of mastoidectomy is not to restore hearing, but to eliminate the infection that can lead to further problems. It is important to note that it is not uncommon to experience some hearing loss with Canal-Wall-Down or Radical Mastoidectomy.
Patients are called for a follow-up ten days and then a month after surgery to examine the ear and ensure it is healing well and not infected. Patients need to stick to the follow-up schedule to prevent facing any issues.
Patients should come and see the doctor if they experience any of the below complications post-operatively:
- Fever
- Hearing loss
- Dizziness or vertigo
- Heavy ear discharge or bleeding
- Facial weakness