Mastoidectomy

What is a mastoidectomy?

A mastoidectomy is a surgery that removes diseased mastoid air cells. These air cells form in the hollow spaces within your mastoid — a sponge-like, honeycomb-shaped bone that sits just behind your ear.

Why is mastoidectomy performed?

A mastoidectomy is necessary when an ear infection (otitis media) spreads to your skull. The procedure is also used to treat cholesteatoma — a noncancerous growth that forms behind your eardrum, often as a complication of chronic ear infections. In many cases, mastoidectomy is performed during cochlear implant surgery.

If you have a ruptured eardrum, your surgeon will perform a mastoidectomy with tympanoplasty. A tympanoplasty is a surgery to repair your eardrum. Tympanoplasty also refers to surgery behind your eardrum even if your eardrum doesn’t need repair.

How serious is a mastoidectomy?

The extensiveness of surgery depends on your unique situation. A simple mastoidectomy will treat disease in your mastoid while leaving your ear canal and middle ear structures completely intact.

A canal-wall-up mastoidectomy or tympanomastoidectomy removes more bone than a simple mastoidectomy. This is done so your surgeon can gain access to the middle-ear space behind your eardrum, including your ossicles — the three tiny bones inside of your ear that transmit sound waves. This procedure leaves your ear canal completely intact.

A canal-wall-down mastoidectomy or tympanomastoidectomy is performed when the disease has damaged your ear canal beyond repair or when the removal of your ear canal is required for the complete removal of disease. This procedure combines your ear canal and mastoid bone into a large open space called a mastoid cavity, or mastoid bowl. The opening of your ear canal is typically enlarged to facilitate the cleaning of your mastoid cavity in the future. This surgery is sometimes called a radical or modified mastoidectomy, and it’s reserved for extensive disease or recurrent (repeating) disease that’s failed a more limited surgery.

What happens before a mastoidectomy?

Your healthcare provider will give you a list of preoperative instructions, which you should follow closely. In some cases, you may need to temporarily stop taking certain medications. Because mastoidectomy is performed under general anesthesia, you’ll also need to arrange for a trusted friend or family member to drive you to and from your appointment.

What happens during a mastoidectomy?

You’ll be placed under general anesthesia to ensure your comfort during the procedure. Next, your surgeon will:

• Create an incision behind your ear to access your mastoid bone. (Your surgeon will place this incision carefully to minimize the appearance of your mastoidectomy scar.)
• Use specialized instruments to open your mastoid bone.
• Remove the infected air cells in your mastoid.
• Close the surgical site with stitches.
• Dress the surgical wound with gauze.

A mastoidectomy surgery usually takes about two to three hours to complete.

How painful is a mastoidectomy?

You shouldn’t feel any pain during your mastoidectomy. However, like any surgery, a mastoidectomy can result in some mild discomfort after the procedure. The incision behind your ear will likely be sore, and your ear may feel full or stuffy. You can manage these side effects with over-the-counter (OTC) pain relievers, such as acetaminophen or ibuprofen. Your surgeon will also give you post-operative instructions that’ll help keep you comfortable during the healing phase.

What happens after a mastoidectomy?

After your mastoidectomy, you’ll wake up in recovery. Your medical team will monitor your progress — and when you’re ready, you’ll be able to go home. Your surgeon will give you specific postoperative guidelines. It’s important to follow these closely.

What are the advantages of a mastoidectomy?

A mastoidectomy can treat chronic ear infections and minimize their recurrence (return). In addition, the procedure can prevent serious complications of cholesteatoma, such as:

• Hearing loss.
• Vertigo.
• Dizziness.
• Facial nerve damage.
• Labyrinthitis.
• Meningitis.
• Brain abscess.

What are the risks or complications of a mastoidectomy?

As with any surgery, there are potential risks or complications. Mastoidectomy complications may include:

• Inner ear hearing loss (sensorineural hearing loss).
• Facial nerve injury, which could cause facial weakness or paralysis.
• A change in taste, which often lasts several months (dysgeusia).
• Ringing in your ear (tinnitus).

How long is recovery after mastoidectomy?

Full mastoidectomy recovery takes about six to 12 weeks. However, most people can return to work, school and other routine activities in approximately one to two weeks.

What’s the outlook for people who undergo mastoidectomy surgery?

Mastoidectomy is largely successful, but the outlook varies based on the reason for the surgery and the type of mastoidectomy performed. The primary goal of mastoidectomy isn’t to restore hearing, but rather, to eliminate infection that can lead to further problems. It’s important to note that some hearing loss is common with radical or canal-wall-down mastoidectomy.

When should I see my healthcare provider?

If you’ve recently undergone a mastoidectomy, you should call your healthcare provider if you have:

• A fever of 100.5 Fahrenheit (38.05 Celsius) or higher.
• Heavy ear bleeding or discharge.
• Facial weakness.
• Dizziness or vertigo.
• Hearing loss.

A note from Cleveland Clinic

If you have recurring, or repeating, ear infections or complications that arise as a result of them, a mastoidectomy may be the best line of treatment. Talk to your healthcare provider about your options. They can tell you if mastoidectomy is something you should consider. Mastoidectomy surgery can get rid of infection, improving your overall health and quality of life.