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Mastoidectomy

Simple mastoidectomy; Canal-wall-up mastoidectomy; Canal-wall-down mastoidectomy; Radical mastoidectomy; Modified radical mastoidectomy; Mastoid obliteration; Retrograde mastoidectomy; Mastoiditis - mastoidectomy; Cholesteatoma - mastoidectomy; Otitis media - mastoidectomy

A mastoidectomy is surgery to remove cells in the hollow, air-filled spaces in the skull behind the ear within the mastoid bone. These spaces are called mastoid air cells.

Presentation

Description

This surgery used to be a common way to treat an infection in mastoid air cells. In most cases, the condition was caused by an ear infection that spread to the bone in the skull. This surgery is not often performed now.

You will receive general anesthesia, so you will be asleep and pain free. The surgeon will make a cut behind the ear. A bone drill will be used to gain access to the middle ear cavity that is behind the mastoid bone in the skull. The infected parts of the mastoid bone or ear tissue will be removed and the cut is stitched and covered with a bandage. The surgeon may put a drain behind the ear to prevent fluid from collecting around the incision. The operation will take 2 to 3 hours.

Why the Procedure Is Performed

Mastoidectomy may be used to treat:

• Cholesteatoma
• Complications of an ear infection (otitis media)
• Infections of the mastoid bone that do not get better with antibiotics
• To place a cochlear implant

Risks

Risks may include:

• Changes in taste
• Dizziness
• Hearing loss
• Infection that persists or keeps returning
• Noises in the ear (tinnitus)
• Weakness of the face
• Cerebrospinal fluid leak

Before the Procedure

You may need to stop taking any medicines that make it hard for your blood to clot 2 weeks before your surgery, including aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and some herbal supplements. Your health care provider may ask you not to eat or drink after midnight the night before the procedure.

After the Procedure

You will have stitches behind your ear and there may be a small rubber drain. You may also have a large dressing over the operated ear. The dressing is removed the day after surgery. You may need to stay in the hospital overnight. Your provider will give you pain medicines and antibiotics to prevent infection.

Outlook (Prognosis)

Mastoidectomy successfully gets rid of the infection in the mastoid bone in most people.

References

Chole RA, Sharon JD. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 140.

MacDonald CB, Wood JW. Mastoid surgery. In: Myers EN, Snyderman CH, eds. Operative Otolaryngology - Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2018:chap 134.

Stevens SM, Lambert PR. Mastoidectomy: surgical techniques. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 143.

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Review Date: 9/21/2022  

Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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