A mastoidectomy is the surgical removal of an infected portion of the mastoid bone, the prominent bone of the skull behind the ear. This surgery, once the only cure for mastoiditis, is now rarely performed since the use of antibiotics has become widespread. Still, certain situations may necessitate this procedure to rid patients of particularly troublesome, drug-resistant symptoms.
A mastoidectomy may be performed in conjunction with another surgical procedure to repair anatomical abnormalities within the middle ear or to remove growths, such as cholesteatomas. Because mastoiditis usually results from the spread of a middle ear infection, also known as otitis media, mastoidectomies are most commonly performed on children since they are most prone to infections of the middle ear.
Reasons For A Mastoidectomy
A mastoidectomy is performed to remove infected air cells within the mastoid bone. Once an infection has spread to the mastoid bone, there is danger that is will spread further, perhaps to the brain as meningitis. Mastoiditis also puts the patient at risk for permanent hearing loss, chronic vertigo or facial paralysis. For these reasons, this illness must be treated effectively and as quickly as possible. If antibiotics are not successful in getting rid of the infection, it will be necessary to remove part or all of the infected mastoid bone and perhaps also perform surgery to drain the middle air with a procedure known as a myringotomy.
A mastoidectomy may also be performed prior to the surgery to put in a cochlear implant to restore a sense of sound to an individual whose hearing is profoundly impaired.
The Mastoidectomy Procedure
The mastoidectomy procedure is performed under general anesthesia. There are several different types of surgery that may be utilized, depending on each patient’s individual condition.
Simple Or Closed Mastoidectomy
During a simple mastoidectomy, a small incision is made within the eardrum to drain excess fluid. This surgery involves making an incision behind the ear, opening the mastoid bone and removing infected tissue.
A radical mastoidectomy involved removal of a major section of the mastoid bone. The eardrum and structures of the middle ear may be entirely removed, although hearing is preserved by leaving the stapes, a small bone of the inner ear, intact.
Modified Radical Mastoidectomy
Modified radical mastoidectomy involves removing some of the middle ear bones and then reconstructing the tympanic membrane through a tympanoplasty procedure.
Risks Of Mastoidectomy
Although considered rare, there are certain risks associated with the mastoidectomy procedure. Some of these may resolve quickly. Others may, unfortunately, be persistent or permanent. These complications may include:
Facial numbness or paralysis
Change in taste
Recovery From A Mastoidectomy
After surgery, the patient will have drainage tubes in place to allow any excess ear fluid to drain. These tubes are usually removed after a day or two. Patients will likely experience some discomfort after surgery, for which the doctor may prescribe pain medication. Antibiotics may be prescribed as well to reduce the risk of infection after surgery. A mastoidectomy is typically successful and patients remain free of infection. In some cases, a hearing aid may be needed to restore hearing loss that could not be avoided or corrected. After a mastoidectomy patients must be careful to keep the ears clean and dry, usually by inserting a Vaseline-coated cotton ball into the ear before bathing. They are also advised to avoid strenuous exercise, air travel and any activity that may create undue pressure in the ear.
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