Mastoidectomy

A mastoidectomy might be required if you have an ear infection that spreads to the skull bone near the ear, called the mastoid bone, causing pain and other hearing and balance symptoms.

The ear, nose and throat (ENT) specialists at The Ohio State University Wexner Medical Center have decades of experience in performing this surgical technique to get you on the road to recovery. Additionally, our nationally ranked Department of Otolaryngology – Head and Neck Surgery has several experts who specialize in many types of ear diseases, so you’ll be in good hands no matter what is causing your ear pain or hearing issues.

What is a mastoidectomy?

When cells in the hollow, air-filled spaces of the skull become infected or inflamed, mastoidectomy surgery is required to remove the infected cells. The mastoid is a spongy, honeycomb-shaped bone behind your ear.

Why is a mastoidectomy performed?

The most common cause of infected cells in the mastoid area is an ear infection that has spread to the skull-bone area. Typically, we’ll use antibiotics first to try to clear up the infection. Sometimes medications aren’t effective, so surgical intervention is needed.

Other conditions that might result in needing a mastoidectomy include:

• Cholesteatoma removal
• Acute or chronic ear infections (chronic otitis media)
• Cochlear implant surgery

How is a mastoidectomy performed?

A mastoidectomy is performed while you’re under general anesthesia. Your surgeon will make an incision behind the ear through which a bone drill will gain access to the mastoid and middle ear cavity. Then, infected cells in the mastoid bone and nearby tissue will be removed.

Besides a mastoidectomy, there are various versions of this surgery that can be done, depending on the location and severity of the infection. These surgeries are called:

• A tympanomastoidectomy - After the infected cells or cholesteatoma are removed, a tympanoplasty is performed to access the middle ear to clear the disease or repair the eardrum.
• A canal-wall-up tympanomastoidectomy - This procedure removes more of the mastoid bone to gain access to the middle ear and ossicles (three tiny bones inside your ear that transmit sound waves), leaving the external ear canal wall bone intact
• A canal-wall-down tympanomastoidectomy, or radical mastoidectomy - A complete removal of your external bony ear canal, this surgery is reserved for those with extensive or recurrent ear disease who haven’t had success with other surgeries.

Is a mastoidectomy a major surgery?

Yes, a mastoidectomy is a major surgery, because it requires general anesthetic, but it’s safe and any complications are usually minor.

Preparing for a mastoidectomy

Your doctor will perform a full examination of your ear and work with an audiologist to test your hearing to determine if a mastoidectomy is the proper treatment for you.

If you proceed with the surgery, it’s important to remember that you’ll be under general anesthesia, so you’ll need to refrain from eating the night before and arrange to have a ride to and from surgery. You also might be put on an antibiotic to prevent infection.

What to expect during a mastoidectomy

You’ll be asleep during the procedure, so you won’t feel pain. Most surgeries last a couple of hours, but you’re typically able to go home later that day or the following day.

Mastoidectomy recovery

You may experience mild discomfort at or near the incision site following the surgery. This should be able to be managed by over-the-counter pain medications, like ibuprofen and acetaminophen. Your ear might feel full or stuffy.

You should expect to take it easy for one to two weeks following a mastoidectomy. If you return to normal activities too early, you could damage the middle or inner ear. A full recovery generally takes six to 12 weeks.

Call your doctor if you develop a fever or heavy discharge or bleeding from the ear.

Risks of a mastoidectomy

Risks associated with a mastoidectomy are generally minor and subside over time. Possible complications include:

• Alteration of taste
• Dizziness
• Facial muscle weakness
• Hearing loss
• Recurring infection
• Tinnitus (ringing in the ear)

Mastoidectomies are largely successful, but it’s important to remember that the primary goal of the surgery is to remove infected cells and make sure the infection doesn’t return — not to restore hearing loss.