Mastoidectomy

Mastoidectomy is a surgical procedure that involves the removal of diseased mastoid air cells. The mastoid is part of the temporal bone, which is located behind the ear. The mastoid air cells are open spaces containing air that help to regulate ear pressure. Mastoidectomy is performed to treat certain diseases of the middle ear, such as chronic otitis media, cholesteatoma, and mastoiditis.

Indications

Mastoidectomy is typically indicated for the following conditions:

• Chronic otitis media that is not responsive to medical therapy
• Cholesteatoma
• Complications of acute otitis media such as mastoiditis, petrositis, or Bezold's abscess
• Facial nerve decompression
• Cochlear implantation
• Removal of glomus jugulare tumors

Procedure

The procedure is performed under general anesthesia. The surgeon makes an incision behind the ear to expose the mastoid bone. The bone is then drilled to remove the diseased air cells. The extent of drilling depends on the extent of the disease. In some cases, the entire mastoid process may need to be removed.

Types of Mastoidectomy

There are three main types of mastoidectomy:

• Simple mastoidectomy: Removal of the mastoid air cells without affecting the middle ear.
• Radical mastoidectomy: Removal of the mastoid air cells, the eardrum (tympanic membrane), and most of the middle ear structures.
• Modified radical mastoidectomy: Removal of the mastoid air cells and some middle ear structures, but the eardrum is left intact.

Complications

Like any surgical procedure, mastoidectomy carries some risks. These may include:

• Hearing loss
• Dizziness or balance problems
• Facial nerve injury
• Infection
• Cerebrospinal fluid leak

Postoperative Care

After the procedure, the patient may need to stay in the hospital for a few days. Pain medication and antibiotics are usually prescribed. The patient is advised to keep the ear dry and avoid blowing the nose. A follow-up appointment is scheduled to remove the stitches and check the healing process.

See Also

• Otitis media
• Cholesteatoma
• Mastoiditis
• Temporal bone

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