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What is Mastoidectomy For?

written by: Emma Lloyd • edited by: Leigh A. Zaykoski • updated: 8/16/2009

Mastoidectomy is uncommon in the United States and other developed countries, but is a common procedure in developing countries, where antibiotic treatment for inner ear infections is not always available.

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    Mastoid Cell Infection

    The inner ear infection known as otitis media is a common childhood disease. An infection of the middle ear is a relatively innocuous condition providing it is quickly treated with antibiotics, but if the infection goes untreated it can worsen into a more serious condition.

    An untreated chronic ear infection can sometimes develop into a disease called mastoiditis, which is an infection of the mastoid air cells of the inner ear. These cells are situated just behind the eardrum. If they become infected, there is a chance that the mastoid bone itself may also become infected. When this happens, serious side effects may result, including damage to facial nerves, facial paralysis, and partial hearing loss.

    Some chronic mastoid infections can be treated successfully with oral or injected antibiotics. Acute infections are often treated with intravenous antibiotics. However, antibiotic treatment is not always successful, as it is difficult for the medication to diffuse through to the area behind the eardrum.

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    Mastoidectomy

    When mastoiditis does not respond to antibiotic treatment, the only other treatment option is a medical procedure called a mastoidectomy. In this procedure the infected mastoid cells are removed, as well as any mastoid bone which is also infected.

    During a mastoidectomy, the patient is put under a general anesthetic. The procedure may be simple or complicated depending on the individual case of mastoiditis; generally, the more severe the infection is, the more complicated the surgery will be.

    There are three main types of mastoidectomy:

    A simple mastoidectomy involves only the removal of infected mastoid cells. In this case the bone itself is not infected and does not need to be removed.

    In a radical mastoidectomy some or all of the mastoid bone is infected and must be removed. This procedure takes more time to complete than the simple mastoidectomy, and is also a riskier procedure in terms of possible side effects. Depending on the severity of the infection hearing loss is a strong possibility.

    A modified mastoidectomy is a procedure in which mastoid bone is removed, and a second procedure called a tympanoplasty is then performed. The tympanoplasty involves reconstruction of the inner ear, and is carried out so that some of the patient’s hearing can be preserved.

    Most people who undergo a mastoidectomy do not require much time for partial recovery, and can go home the same day of the operation.

    Despite this it can take several weeks for healing and full recovery. Mild discomfort in the ear is a common side effect during the recovery period. Severe pain is not common, and requires prompt treatment as this may be a sign of infection.

    Other possible side effects following surgery include impaired balance, dizziness, tinnitus, weakness of facial muscles, and partial hearing loss. These symptoms are usually temporary, but in the case of radical mastoidectomy some may end up being permanent.

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    References

    Dominique C Fontenette, MD. Mastoiditis

    National Institute of Health Medline Plus: Mastoidectomy

    National Institute of Health Medline Plus: Mastoiditis