Treatment of Mastoidectomy Surgery

Introduction

Mastoidectomy surgery is a critical procedure performed to remove infected air cells inside the mastoid bone located just behind the ear. This surgery becomes necessary when chronic ear infections, cholesteatoma, or untreated middle ear conditions start damaging nearby structures. Understanding the treatment of mastoidectomy surgery, its purpose, techniques, recovery steps, risks, and long-term care can help patients feel confident and well-prepared for the journey ahead.

What is Mastoidectomy Surgery?

A mastoidectomy is a surgical procedure that removes diseased or infected portions of the mastoid bone. The mastoid bone contains air cells that can get severely infected due to repeated ear infections or cholesteatoma growth. When medication fails to treat the infection completely, a mastoidectomy becomes the most effective option to eliminate disease, prevent complications, and preserve hearing.
This operation is performed by an ENT specialist (otolaryngologist) using microsurgical tools to ensure precision and safety.

Why is Mastoidectomy Surgery Required?

There are several reasons why ENT surgeons recommend mastoidectomy. The most common include:

1. Chronic Otitis Media (COM) :- Repeated and persistent middle ear infections can spread to the mastoid bone, causing damage that antibiotics alone cannot treat. Surgery ensures complete cleaning of the infected space.
2. Cholesteatoma :- A cholesteatoma is a destructive skin growth inside the ear that can erode bones, nerves, and hearing structures. Mastoidectomy helps remove this growth entirely to prevent complications.
3. Prevention of Dangerous Complications :- Untreated mastoid infections can lead to abscess formation, facial nerve paralysis, meningitis, and even brain infections. Early surgical treatment can prevent these risks.
4. Improving Hearing and Ear Function :- Sometimes mastoidectomy is combined with tympanoplasty to repair the eardrum and improve hearing quality.

Types of Mastoidectomy Surgery

While the core purpose is the same, mastoidectomy can be performed in different ways depending on the severity of infection and the patient’s ear condition.

1. Simple (Cortical) Mastoidectomy :- This is done to remove infection from the mastoid air cells without altering the middle ear structures. It is the most common and less extensive type of mastoidectomy.
2. Modified Radical Mastoidectomy :- This method is used when the infection is more severe. The surgeon removes a larger portion of the diseased bone but preserves important middle ear structures to maintain hearing.
3. Radical Mastoidectomy :- This is performed in rare, advanced cases where extensive infection or cholesteatoma has caused significant damage. It involves removing most middle ear structures, resulting in hearing loss but completely eliminating the infection.
4. Canal Wall Up (CWU) / Canal Wall Down (CWD) :- These variations describe whether the ear canal wall is preserved or removed. CWU aims to maintain ear structure, whereas CWD is often used for advanced cholesteatoma.

How is Mastoidectomy Surgery Performed?

The procedure is generally performed under general anesthesia. Here is a step-by-step overview:

1. A small incision is made behind the ear.
2. Using a surgical drill, the surgeon accesses the mastoid bone.
3. Infected or damaged air cells are removed.
4. The surgeon cleans and reconstructs affected ear structures if needed.
5. The incision is carefully closed, and a sterile dressing is applied.

The entire process takes 1 to 3 hours, depending on the severity of the infection.

Post-Operative Care and Recovery

Recovery after mastoidectomy is smooth when proper care is followed. Patients typically experience mild discomfort, drainage, and ear fullness for a few days. Key recovery tips include:

• Take prescribed antibiotics and pain medications regularly.
• Avoid blowing your nose forcefully for at least 2 weeks.
• Keep the ear dry and avoid swimming until the surgeon permits.
• Attend all follow-up appointments for ear cleaning and healing checks.
• Refrain from strenuous activities for about 10–14 days.
  

Most patients resume normal activities within one to two weeks, depending on healing progress.

Possible Risks and Complications

Although mastoidectomy is a safe surgical procedure, some complications may occur in rare cases:

• Temporary or permanent hearing loss
• Dizziness or imbalance
• Tinnitus (ringing in the ear)
• Facial nerve injury
• Persistent infection
• Taste disturbances

Choosing an experienced ENT surgeon greatly minimizes these risks.

Long-Term Treatment and Follow-Up Care

Proper follow-up after mastoidectomy ensures complete healing and prevents recurrence of infection. ENT specialists may schedule periodic ear cleaning, hearing tests, and imaging scans. If tympanoplasty or ossicular reconstruction was performed, additional follow-up may be needed to monitor hearing recovery. Patients with cholesteatoma may require long-term observation because this condition can return even after surgery.

Conclusion

The treatment of mastoidectomy surgery plays a vital role in managing chronic infections, preventing severe complications, and restoring ear function. With advancements in ENT microsurgery, mastoidectomy has become safe, precise, and highly effective for treating mastoid bone infections and cholesteatoma. Early diagnosis, proper surgical planning, expert ENT care, and regular follow-ups together contribute to successful outcomes and improved quality of life.