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isit Pristyn Care to undergo a safe and effective mastoidectomy. At Pristyn Care, we work with expert and experienced ENT surgeons who have ample experience in performing various surgeries, including mastoidectomy. Book an appointment with us now.
isit Pristyn Care to undergo a safe and effective mastoidectomy. At Pristyn Care, ... Read More
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A mastoidectomy is a surgical procedure that helps in removing diseased mastoid air cells. The mastoid is a part of your skull located behind your ear. It’s filled with air cells made of bone and looks like a honeycomb. The diseased cells are often the result of an ear infection that has spread into your skull. Mastoidectomy is also helpful in the removal of abnormal growth of the ear, known as cholesteatoma.
Each mastoidectomy is different because of the variable pneumatization patterns of the temporal bone. The primary indications for performing a mastoidectomy include acute mastoiditis, chronic mastoiditis with its sequelae, and cholesteatoma. Mastoidectomy can also be performed in coordination with tympanostomy tube placement in patients with complications of chronic otitis media or acute otitis media. Mastoidectomy also serves as a key surgical approach for many otological procedures, including labyrinthectomy, facial nerve surgery, cochlear implantation, petrous apex lesions, and lateral skull base tumors, endolymphatic sac surgery.
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A mastoidectomy surgery is helpful in treating complications of chronic otitis media (COM). COM is an ongoing ear infection of the middle ear. A cholesteatoma, which is a skin cyst, can be a complication of these ongoing infections. The cyst grows gradually over time and may lead to serious complications such as:
A healthcare provider may also perform a mastoidectomy to put in acochlear implant. It is a small, complex electronic device that can help provide you with a sense of sound if you’re profoundly deaf or severely hard of hearing. Moreover, mastoidectomy surgery can also remove abnormal growths at the base of your skull.
Diagnosis
A mastoidectomy can be performed for either a cholesteatoma or a severe mastoid infection. Its symptoms can often be confused with other ear infections and problems, thus, your ENT doctor needs to perform a thorough diagnosis before drafting a treatment plan.
To confirm the diagnosis, you may need several diagnostic tests like blood tests, along with imaging scans like MRI, CT scan, and X-rays of your head and ear area. The scan will help determine the severity of mastoid degeneration. In case there is a chance that the infection has spread to the skull, you may also need a lumbar puncture or spinal tap.
Treatment
Depending on the severity of your condition, your surgical treatment may vary a little. A simple mastoidectomy involves only the removal of the diseased part of the bone and leaves the ear canal intact. However, if you need extensive surgery, then your surgeon may need to combine your ear canal and mastoid bone by widening the ear canal to preserve hearing function. This type of surgery is known as a radical or modified mastoidectomy.
The surgery is usually performed under local anesthesia, and you would be able to go home on the same day as the surgery. The surgical incision is created behind the ear to minimize the scar appearance, and once the infected areas of bone are removed, the incision is closed with sutures and dressed appropriately. The complete procedure takes about 2-3 hours to complete.
There are several types of mastoidectomy surgeries, including:
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Mastoidectomy and tympanoplasty are different surgical procedures that target different areas of the ear and serve different purposes. Here are the key differences between both surgeries:
Mastoidectomy:
Tympanoplasty:
In some cases, mastoidectomy and tympanoplasty may be performed simultaneously, particularly when there is a combination of middle ear damage, cholesteatoma, or chronic infection. The specific surgical approach and techniques employed usually depend on the individual’s condition and the expertise of the surgeon. Consulting with an ENT specialist is vital to determine the most suitable procedure for your specific ear condition. They assess your symptoms, conduct necessary tests, and recommend the appropriate surgical approach to address your unique needs.
A mastoidectomy is usually performed for either a cholesteatoma or a severe mastoid infection. Its symptoms can often be confused with other ear infections and problems, thus, an ENT surgeon needs to perform a thorough diagnosis before drafting a treatment plan.
A doctor usually suggests a variety of diagnostic tests, including blood tests, along with imaging scans like MRI, CT scan, and X-rays of your head and ear area. The scan helps in determining the severity of mastoid degeneration. In case there is a chance that the infection has spread to the skull, you may also need a lumbar puncture or spinal tap
The mastoidectomy surgery is performed in an operating room by an experienced ENT surgeon using an operating microscope. The surgery is usually performed under the influence of general anesthesia. In the case of a simple mastoidectomy surgery, a surgeon accesses the mastoid bone by creating an incision behind the ear.
A surgeon usually makes an incision precisely to reduce the chances of scarring in the incision area. Afterward, a surgeon uses a microscope and other specialized instruments to open the mastoid bone and keep the area free of bone dust by using the suction irrigation method.
After that, they remove the infected air cells from within the mastoid bone and stitch up the surgical site. A surgeon dresses the surgical wound in gauze to keep it clean and dry. Sometimes, a surgeon may use a facial nerve monitor during the procedure to limit facial nerve injury. A simple mastoidectomy surgery typically takes 2-3 hours to complete.
Some common advantages of mastoidectomy surgery include
Listed below are some preparation tips to follow to reduce the chances of complications during surgery:
It is important to note that these are general guidelines, and it’s important to adhere to the specific instructions given by your healthcare provider. They also provide personalized instructions based on your individual circumstances to ensure your safety and optimize the surgical outcome.
Generally, it takes 8-12 weeks to recover completely after the surgery. In some cases, patients start feeling better in a few days, while others may take up to 14 days to recover fully.
During recovery, you can find stitches near your ear after waking up and can experience headaches, numbness, and discomfort. In some cases, pain can occur for the first few days after surgery. A doctor usually recommends activity restrictions for up to 3-4 weeks to promote healing.
Some common risks and complications associated with mastoidectomy surgery are as follows:
Listed below are some lifestyle changes that you can adopt to promote recovery after surgery:
It’s important to note these lifestyle changes are general in nature, and it’s crucial to follow the specific instructions provided by your healthcare provider. They will provide personalized guidance based on your unique situation to ensure a smooth recovery and optimal results.
The average cost of mastoidectomy surgery in India is INR 65000. This is the estimated cost of the surgery, the final cost can vary depending on various factors, including:
Mastoid surgery is typically performed to treat chronic ear infections or complications from other ear conditions. If a mastoidectomy is deemed medically necessary by a healthcare provider, it is typically covered by health insurance.
Many health insurance plans include coverage for surgical procedures, including mastoidectomy, as a covered benefit. The specific details of coverage usually depend on the individual’s insurance plan, including the type of plan, the deductible, copayment, and coinsurance amounts.
Some non-surgical treatment options are as follows:
Antibiotics: In mild cases or early-stage infections, healthcare providers may prescribe oral or intravenous antibiotics to control the infection and reduce inflammation. However, antibiotics alone may not completely eliminate the diseased mastoid air cells and may require additional treatment.
Ear drops: For external ear infections or inflammation, healthcare providers may recommend antibiotic or anti-inflammatory ear drops to alleviate symptoms and manage the infection.
Watchful waiting: In certain cases where the infection is not severe and symptoms are mild, a period of observation and regular follow-up appointments may be advised. This approach involves closely monitoring the condition to ensure it doesn’t worsen or develop complications. However, it’s important to note that watchful waiting may not be suitable for more advanced or persistent cases.
It is crucial to consult with an experienced ENT surgeon to determine the most appropriate treatment approach for your specific condition. They first assess the severity of the infection, evaluate your symptoms, and provide recommendations based on the available non-surgical options.
It’s important to understand that mastoidectomy surgery is often necessary when non-surgical treatments prove insufficient in addressing the underlying issue. Surgical removal of infected or diseased mastoid air cells remains the most effective approach for resolving chronic or severe mastoiditis and related conditions.
Before surgery, you must ask the following questions to your surgeon to have a better understanding of the procedure and the risks and complications associated with it:
Mastoidectomy surgery is successful in about 80-90% of cases, and there is a very rare chance of recurrence after the surgery. You may get mild ear infections from time to time, but they can be easily managed via medications.
It is usually safe to remove the dressing after 2 days, but you need to make sure the water and other foreign substances do not enter the ear canal. You can use cotton laced with antibiotics or Vaseline to keep the ear canal covered while bathing.
If you have a perforated eardrum in addition to a mastoid/middle ear infection, then you may need a tympanoplasty with mastoidectomy. The surgery will be performed at the same time, and you will recover within 6-8 weeks.
If you have ear problems and suspect you might need a mastoidectomy, then you should consult an ENT specialist (ear, nose, and throat doctor).
No, the surgery is performed under local anesthesia, so there is no pain during the surgery. After the surgery, there might be a little pain and discomfort during the recovery period, which can be managed through over-the-counter medications.
In severe cases where extensive removal of mastoid bone is necessary, a little hearing loss is common after the surgery, but generally, during a simple mastoidectomy, the ear canal remains intact, and there is no hearing loss.
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