Mastoidectomy

Mastoidectomy Surgery in Hyderabad, India

The mastoid is the part of the skull located behind the ear which is filled with air cells made of bone and has a honeycomb-like appearance. Infections of the ear can spread to the skull, which results in disease of the air cells. To remove such clusters of diseased mastoid air cells, surgery is performed. This surgery is known as a mastoidectomy. This surgical procedure is also used to remove abnormal growth in the ear region known as cholesteatoma. 

At CARE Hospitals, our multidisciplinary staff of medical and surgical specialists along with care providers offer comprehensive diagnoses, and treatments using state-of-the-art machines equipped with the latest technology and minimally invasive procedures to ensure faster, complication-free recovery, shorter hospital stays, and overall improvement of the general health of the patient.

Why Do I Need a Mastoidectomy? 

A mastoidectomy may be recommended for various medical conditions affecting the mastoid bone and structures within the ear. Common reasons for undergoing mastoidectomy include:

• Chronic Ear Infections: Mastoidectomy is often performed to treat chronic or recurrent ear infections that have not responded well to other treatments. The procedure helps remove infected or diseased tissue from the mastoid air cells.
• Cholesteatoma: Cholesteatoma is a non-cancerous skin growth that can develop in the middle ear. If left untreated, it can cause damage to the ear structures and lead to hearing loss. Mastoidectomy is employed to remove the cholesteatoma and prevent its recurrence.
• Complications of Ear Infections: In some cases, ear infections can lead to the development of complications such as mastoiditis, an inflammation or infection of the mastoid bone. Mastoidectomy may be necessary to address this condition.
• Middle Ear Abnormalities: Mastoidectomy may be part of the surgical approach to address certain middle ear abnormalities or congenital conditions affecting ear structures.

Why perform mastoidectomy?

Mastoidectomy is used to treat chronic otitis media (COM), which is the medical term for chronic ear infection in the middle ear. A chronic otitis media can give birth to some other complications such as a skin cyst, otherwise known as cholesteatoma. The cysts grow gradually over time and can lead to some serious complications such as:

• Brain abscess,

• Deafness,

• Vertigo or dizziness,

• Damage to the facial nerves that can lead to facial paralysis,

• Inflammation of the membranes of the brain (meningitis),

• Inflammation of the inner ear (labyrinthitis),

• Continual ear drainage.

Mastoidectomy may also be done in case medications do not improve conditions of infections in the mastoid bone. It may also be performed to place a cochlear implant, which is a complex electronic device that can help a patient with impaired hearing to get a sense of sound.

How serious is a mastoidectomy?

The extent of the surgery is tailored to your specific circumstances. A simple mastoidectomy addresses mastoid disease while preserving your ear canal and middle ear structures entirely.

A canal-wall-up mastoidectomy or tympanomastoidectomy involves the removal of more bone compared to a simple mastoidectomy. This is necessary for your surgeon to access the space behind your eardrum, including the ossicles—the three small bones responsible for transmitting sound waves. Importantly, this procedure maintains the integrity of your ear canal.

Conversely, a canal-wall-down mastoidectomy or tympanomastoidectomy becomes necessary when disease has irreparably damaged your ear canal or when complete disease removal requires the elimination of your ear canal. This comprehensive procedure combines your ear canal and mastoid bone, creating a large open space known as a mastoid cavity or mastoid bowl. Typically referred to as a radical or modified mastoidectomy, this surgery is reserved for cases of extensive or recurrent disease that has not responded to more limited interventions. The opening of your ear canal is often enlarged to facilitate future cleaning of the mastoid cavity.

Mastoidectomy Surgery Procedure

What happens before a mastoidectomy?

Your healthcare provider will provide you with a set of instructions to be followed before the surgery, and it's crucial to adhere to them diligently. In certain instances, you might be required to temporarily discontinue the use of specific medications. Given that mastoidectomy is conducted using general anesthesia, it's essential to organize transportation to and from the appointment with the assistance of a reliable friend or family member.

What happens during mastoidectomy?

CARE Hospitals offer various mastoidectomy procedures after thorough diagnosis and discussion at length by our specialists with the patient to chalk out a proper surgical method suitable to the needs of the patient taking care of other health problems that he may be suffering from.

The variations of mastoidectomy procedures available are:

• Simple mastoidectomy: Simple mastoidectomy is the surgical procedure in which a surgeon opens the mastoid bone to remove the infected air cells and drain the middle ear.

• Radical mastoidectomy: In radical mastoidectomy, the surgeon may remove the mastoid cells, the eardrum, most of the ear structures, and the ear canal. This procedure is performed when the mastoid disease is complicated.

• Modified radical mastoidectomy: The modified radical mastoidectomy is a less severe form of radical mastoidectomy surgery which involves the removal of the mastoid air cells along with some of the middle ear structures.

The infected parts of the mastoid bone or ear tissue can be removed by gaining access to the middle ear cavity behind the mastoid bone in the skull. This surgical treatment is performed under general anaesthesia administered by our highly experienced anaesthesiologist in collaboration with our ENT surgeons and usually takes about two to three hours. A cut is made behind the ear. 

What happens after the mastoidectomy surgery?

There may be some soreness, headache, discomfort, and numbness after the surgery. There may be stitches behind the ear and there may be a small rubber drain attached to the place behind the ear. There may also be bandages around the operated ear which may be removed a day after the surgery. An overnight stay at the hospital may be necessary. 

Recovery

Our ENT specialists and care providers take great care to ensure faster recovery without any complications by using proper medications by following international standards of protocols. For headaches and discomfort, pain reliever medications may be administered. Antibiotics may also be given to treat any postoperative infection at the site of operation. 

Routine check-ups may be scheduled to ensure proper recovery of the wound due to the surgery and provide some suggestions to follow or avoid after the surgery. Some of the general instructions include: 

• Avoiding swimming,

• Avoiding strenuous activities,

• Avoiding putting water on the operated ear,

• Avoid putting pressure on the ear.

Restrictions may continue for at least two to four weeks following the surgery.

What are the risks or complications of a mastoidectomy?

Some hearing loss is common with both radical mastoidectomy and modified radical mastoidectomy. However, there may be some complications arising afterwards due to the surgery:

• Facial nerve paralysis or weakness- this is a rare facial complication arising due to facial nerve surgery.

• Sensorineural hearing loss- this is a type of inner ear hearing loss.

• Vertigo- dizziness may be experienced for several days following the surgery,

• Taste changes- this may be caused after the surgery and make food taste metallic, sour or otherwise off. This condition often resolves within some time in a few months.

• Tinnitus- this is the sensation of hearing abnormal noises in the ear such as ringing, buzzing, or hissing.