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Advanced Mastoidectomy Surgery In The Best Ent Clinics

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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    Dr. Saloni Spandan Rajyaguru (4fb10gawZv)

    Dr. Saloni Spandan Rajya...

    MBBS, DLO, DNB
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    Dr. Manu Bharath (mVLXZCP7uM)

    Dr. Manu Bharath

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    13 + Years

    Bangalore

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    Dr. Divya Badanidiyur

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    13 + Years

    Bangalore

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    Dr. Shilpa Shrivastava (LEiOfhPy1O)

    Dr. Shilpa Shrivastava

    MBBS, MS
    13 Yrs.Exp.

    4.5/5

    13 + Years

    Hyderabad

    ENT/ Otorhinolaryngologist

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  • What is mastoidectomy?

    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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    When is a Mastoidectomy Required?

    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:

    • Abscess in the brain
    • Deafness
    • Dizziness or vertigo
    • Damage to your facial nerve that causes facial paralysis
    • Meningitis, or inflammation of the membranes of your brain
    • Labyrinthitis, or inflammation of your inner ear
    • Ongoing ear drainage

    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.

    Are you going through any of these symptoms?

    What happens during a mastoidectomy?

    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.

    What are the Types of Mastoidectomy?

    There are several types of mastoidectomy surgeries, including:

    • Simple mastoidectomy: In a simple mastoidectomy, a surgeon opens the mastoid bone and removes the infected area. It treats the mastoid while leaving the ear canal and middle ear structures completely intact.
    • Canal-wall-up mastoidectomy: A canal wall-up mastoidectomy removes more bone than a simple mastoidectomy does. Sometimes, removing more of the bone is necessary to access the middle ear.
    • Canal-wall-down mastoidectomy: A canal wall-down (or radical) mastoidectomy is usually performed when the infection severely damages the ear canal. Usually, a surgeon attempts to preserve as much hearing as possible. But in some cases, they may need to remove the eardrum and middle ear structures completely. In a modified radical mastoidectomy, the surgeon leaves some of the middle ear bones in place and rebuilds the eardrum.

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    What is the Difference Between Mastoidectomy and Tympanoplasty?

    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:

    • Purpose: Mastoidectomy surgery involves the removal of infected or diseased mastoid air cells. It is typically performed to treat conditions like chronic ear infections, mastoiditis, or cholesteatoma.
    • Surgical Area: Mastoidectomy focuses on the mastoid bone located behind the ear, with potential involvement of the middle ear.
    • Goals: The main objectives of mastoidectomy include eliminating infection, preventing complications, preserving or improving hearing, and excising cholesteatoma.

    Tympanoplasty:

    • Purpose: Tympanoplasty surgery is aimed at repairing a perforated eardrum or reconstructing the middle ear structures, addressing issues such as chronic eardrum perforations, hearing loss, or middle ear damage.
    • Surgical Area: Tympanoplasty surgery concentrates on the middle ear, specifically the eardrum and ossicles (malleus, incus, and stapes).
    • Goals: Tympanoplasty seeks to restore the integrity of the eardrum, reconstruct the middle ear, enhance hearing, and prevent complications like recurring infections.

    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.

    Diagnostic Tests Before Mastoidectomy

    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

    What Happens During Mastoidectomy Procedure?

    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.

    Benefits of Mastoidectomy Surgery

    Some common advantages of mastoidectomy surgery include

    • Treatment of chronic ear infections: Mastoidectomy can effectively address persistent ear infections that have not responded to other treatments, such as antibiotics.
    • Prevention of complications: By removing infected or damaged tissue, mastoidectomy helps prevent the spread of infection to nearby structures, such as the brain or inner ear.
    • Relief from symptoms: Mastoiditis, that causes pain and swelling behind the ear, can be managed through mastoidectomy surgery.
    • Restoration of hearing: Mastoidectomy, combined with other procedures like tympanoplasty, can help improve or restore hearing in cases where chronic ear infections or cholesteatoma have caused hearing loss.
    • Elimination of cholesteatoma: Mastoidectomy is usually performed to remove cholesteatoma, which can damage the middle ear and surrounding structures. By excising the cholesteatoma, the surgery aims to prevent further complications and preserve hearing.
    • Improved outcomes with cochlear implantation: In cases of severe hearing loss or deafness, mastoidectomy can create a suitable environment for cochlear implantation, increasing the chances of successful implantation and improving overall outcomes.

    Preparation Before Mastoidectomy

    Listed below are some preparation tips to follow to reduce the chances of complications during surgery:

    • Medical assessment: A healthcare provider usually conducts a comprehensive evaluation of your medical history, including any previous ear conditions or surgeries. They may also order specific tests to determine the extent of the problem and plan the appropriate surgical approach.
    • Medication review: Discuss all medications, including prescriptions, over-the-counter drugs, and supplements, with your healthcare provider. They will provide instructions on whether to continue or temporarily discontinue any medications before the surgery.
    • Fasting: A healthcare provider usually suggest you to fast for a specified period before the surgery. This ensures an empty stomach during the procedure, reducing the risk of anesthesia-related complications.
    • Avoidance of substances: A doctor usually advises to refrain from consuming alcohol, tobacco, or specific medications or supplements leading up to the surgery, as they can affect anesthesia and healing.
    • Pre-operative instructions: You must follow all the instructions provided by your healthcare provider. These may include guidelines on fasting, using special antibacterial soap for showering and removing makeup, jewelry, or nail polish.
    • Transportation and support arrangements: Since mastoidectomy involves anesthesia, you must arrange transportation to and from the surgical facility. It’s also helpful to have a friend or a family person to accompany you for support during and after the surgery.
    • Addressing concerns: Before the surgery, ensure you discuss all the questions or concerns with your healthcare provider. Open communication helps you understand the procedure, potential risks, expected outcomes, and post-operative care.

    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.

    Recovery After Mastoidectomy Surgery

    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.

    Risk & Complications Associated with Mastoidectomy

    Some common risks and complications associated with mastoidectomy surgery are as follows:

    • Infection: In some cases, there is a chance of developing an infection at the surgical site or in the surrounding area, which may require additional treatment.
    • Bleeding: Bleeding occurs during or after the surgery, and excessive bleeding may require intervention to control it.
    • Injury to surrounding structures: Due to the proximity of other structures like the facial nerve, inner ear, and brain, there is a chance of injury during surgery, which can lead to complications such as facial weakness, hearing loss, dizziness, or cerebrospinal fluid (CSF) leakage.
    • Changes in taste or balance: The surgery may affect the nerves responsible for taste and balance, potentially causing temporary or permanent changes in these sensations.
    • Persistent or recurrent infection: In some cases, mastoidectomy may not completely resolve the infection, or the infection may reoccur after surgery, necessitating further treatment or additional procedures.
    • Cosmetic effects: In some cases, mastoidectomy can result in changes to the shape or appearance of the area behind the ear, though efforts are made to minimize cosmetic impacts.
    • Rare complications: In some rare instances, serious complications such as meningitis, facial nerve injury, dural injury, or inner ear damage may occur, requiring immediate medical attention.

    Lifestyle Changes After Mastoidectomy Surgery

    Listed below are some lifestyle changes that you can adopt to promote recovery after surgery:

    • Rest and recovery: Give yourself enough time to rest and recover after surgery. Follow all the recommendations provided by your healthcare provider. Avoid strenuous activities and intense exercises.
    • Medication and wound care: Take all the prescribed medications as instructed, including antibiotics and pain relievers. Follow the wound care instructions provided, such as cleaning the incision site and changing dressings. Inform your healthcare provider if you notice any signs of infection.
    • Ear protection: Protect your ear from water and excessive moisture to reduce the chances of contamination. Use earplugs or avoid activities like swimming until it’s deemed safe to do so.
    • Follow-up appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your healing progress, remove sutures or dressings, and assess your overall recovery.
    • Pressure changes: You must avoid activities that cause sudden changes in pressure, such as scuba diving or flying, during the healing period to prevent discomfort and potential complications.
    • Lifestyle adjustments: Consider lifestyle modifications recommended by your healthcare provider, such as refraining from smoking to support the healing process and maintaining a healthy diet to aid overall healing and immune function.
    • Contact healthcare provider: Promptly reach out to your healthcare provider if you experience unusual or concerning symptoms, such as severe pain, fever, increased drainage, or changes in hearing.

    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.

    Cost of Mastoidectomy Surgery

    The cost of mastoidectomy surgery in India typically ranges from around INR 55,000 to INR 75,000. This is the estimated cost of the surgery, the final cost can vary depending on various factors, including:

    • Choice of treatment hospital
    • Choice of the hospital room
    • The consultation fee of the ENT surgeon
    • Additional surgical procedures required with mastoidectomy
    • Cost of diagnostic tests
    • Cost of Anesthesia and other surgical equipment
    • Type of surgery being performed
    • Cost of medications and postoperative care required
    • Post-surgery consultation charges

    Mastoidectomy Surgery Coverage Under Insurance

    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.

    Non-Surgical Treatment To Remove Diseased Mastoid Air Cells

    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.

    Questions to Ask Your Surgeon

    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:

    • What is the reason for mastoidectomy?
    • Is mastoidectomy an emergency procedure?
    • What are the risks and complications of mastoidectomy surgery?
    • What precautions do I need to take before the surgery to reduce the chances of complications during the surgery?
    • How long will it take to recover completely after the mastoidectomy surgery?
    • What is the cost of mastoidectomy surgery in India?
    • Is mastoidectomy a painful procedure?
    • What to eat after mastoidectomy surgery to recover quickly after the surgery?
    • What is the age limit for mastoidectomy surgery?
    • What is the success rate of mastoidectomy surgery?
    • What are the two main types of mastoidectomy? 
    • How long is a mastoidectomy surgery?
    • What is the difference between mastoidectomy and tympanoplasty?
    • What is the other treatment except for mastoidectomy surgery?
    • What are the risk factors for mastoidectomy surgery?
    • What is the recovery process after a mastoidectomy?
    • How is a mastoidectomy performed?
    • How is a cortical mastoidectomy performed?
    • In what cases mastoidectomy with tympanoplasty is required?

    Frequently Asked Questions

    Can I still get ear infections after a mastoidectomy?

    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.

    How long will my ear need dressing after the mastoid surgery?

    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.

    Would I need tympanoplasty with mastoidectomy surgery?

    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.

    Which doctor should I consult for a mastoidectomy?

    If you have ear problems and suspect you might need a mastoidectomy, then you should consult an ENT specialist (ear, nose, and throat doctor).

    Is mastoidectomy painful?

    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.

    Will I experience any hearing loss after a mastoidectomy?

    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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    Content Reviewed By
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    Dr. Saloni Spandan Rajyaguru
    14 Years Experience Overall
    Last Updated : February 23, 2024