What is it?
Mastoidectomy is a surgical procedure performed for chronic middle ear disease called the cholesteatoma. Cholesteatoma is a bone eroding disease of the middle ear that can damage the mechanisms of hearing and balance. Surgery is required to prevent further damage due to the disease. If left untreated can lead to complications like meningitis(spread to brain), labyrinthitis(spread to inner ear) and facial nerve palsy.
What is the aim of the procedure?
The primary purpose of the procedure is to clear the disease present in the middle ear cleft. Reconstruction of the hearing mechanism to improve the hearing is considered secondary. Though attempt will be made to restore hearing as much as possible, a hearing loss of atleast 30dBHL is expected.
What is done during the procedure?
During the procedure the middle ear is examined to identify and remove the disease present in the middle ear and the mastoid and to repair the ossicles and ear drum to improve the hearing. Based on the extent of the disease, it may be performed through the external auditory canal or through an incision behind the ear.
The procedure will be carried out under general anaesthesia. If you have any anaesthetic concerns, please discuss with your anaesthetist.
What are the risks associated with the procedure?
Bleeding, is even more common when on certain specific drugs like anti platelets and anti-coagulants.
Infection of the operated site.
Facial nerve paralysis.
Progressive hearing loss(due to removal of disease ossicles).
Giddiness.
Tinnitus (very rare).
Recurrence of the disease.
Post-operative care and follow-up:
Following the procedure, you will be having a dressing over the ear which will be changed on the day after the surgery. Tingling sensation/numbness around the ear, crackling sensation in the ear and reddish discharge from the ear are expected for a period of up to 1 month after the surgery. You will be discharged on the day following the surgery, if no complications are encountered. Suture removal will be performed on the 7th postoperative day.
It is advisable to avoid sleeping on the side of the operated ear until complete healing occurs. Swimming, air travel, straining, cold food intake are to be avoided. Avoid forceful blowing of nose and head bath for 2-4 weeks. To keep ear dry by placing an ear plug coated with Vaseline® petroleum jelly or coconut oil for a period of 1 month.
You will have review with your doctor every 6-8 months for examination of the ear and cleaning if required. Giddiness may occur when cold or warm air enters the ear. Persistent ear discharge may be present which will be treated with medications.
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