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. Mastoidectomy is often used to treat cholesteatoma, or ear infections that have spread into your skull. It’s also used when placing cochlear implants.
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.
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 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.