A mastoidectomy is a surgical procedure designed to remove infection in the bone behind the ear (mastoid bone). Its purpose is to create a “safe” ear and prevent further damage to the hearing apparatus.
Mastoidectomy is often indicated for other diseases that spread to the mastoid bone, such as cholesteatoma. Cholesteatoma is an abnormal skin growth in the middle ear behind the eardrum . Repeated infections and/or and a tear or retraction of the eardrum can cause the skin to form an expanding sac.
Cholesteatomas often devolop as cysts or pouches that shed layers of old skin, which build up inside the middle ear. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear. Hearing loss, dizziness, and facial nerve paralysis rarely, also continued cholesteatoma growth may result in intracranial complications..
A mastoidectomy is also helpful in preventing further complications of mastoiditis. These include meningitis (infection in the fluid surrounding the brain), brain abscess (pocket of infection in the brain), or blood clots in the veins of the brain.
This procedure allows complete removal of these benign yet destructive growths.
Hearing tests and CT scan are also obtained prior to surgery.
A mastoidectomy is performed with the patient fully asleep (under general anesthesia). A surgical cut (incision) is made behind the ear. The mastoid bone is then exposed and opened with a surgical drill. The infection is then removed. The incision is closed with stitches under the skin. A drainage tube may also be placed.
Depending on the amount of infection or cholesteatoma present, various degrees of mastoidectomies can be performed.
In a simple mastoidectomy, the surgeon opens the bone and removes any infection. A tube may be placed in the eardrum to drain any pus or secretions present in the middle ear.
A modified radical mastoidectomy means that some middle ear bones are left in place and the eardrum is repaired-Tympanoplasty.
A radical mastoidectomy removes the most bone and is indicated for extensive spread of a cholesteatoma. The eardrum and middle ear structures may or may not be completely removed. Usually the stapes bone is spared if possible to help preserve some hearing.
Bleeding and/or infection of the wound area are possible complications with any incision. Antibiotics and good surgical technique help prevent this. Some blood-tinged drainage is common in the first two days.
Complications can include injury to the balance system, hearing loss, or facial nerve. Dizziness or a ringing in the ear (tinnitus) could also result.