Mastoidectomy is a surgical procedure to remove infected or diseased tissue from the mastoid bone, which is located behind the ear. The mastoid bone is a part of the temporal bone and contains air cells that can become infected or diseased, causing symptoms such as ear pain, drainage from the ear, and hearing loss. Mastoidectomy surgery clears the infection, restores hearing and promotes better drainage of the air cell system thereby preventing further infections.
The procedure is usually performed under general anesthesia and involves making an incision behind the ear to access the mastoid bone. The infected or diseased tissue is then removed, the ear drum is repaired (tympanoplasty) and the incision is closed with stitches. In some cases, repair of the small bones (ear ossicles) in the middle ear is carried out (ossicular reconstruction) if it is found that the ossicles are diseased.
Some common indications for a mastoidectomy include:
Chronic or recurrent ear infections: Mastoidectomies are often performed to treat chronic or recurrent ear infections that have not responded to other forms of treatment, such as antibiotics.
Mastoiditis: Mastoiditis is an infection of the mastoid bone that can cause swelling and inflammation. A mastoidectomy may be necessary to remove the infected tissue and prevent the spread of the infection.
Cholesteatoma: A cholesteatoma is a noncancerous growth that can develop in the ear and cause damage to the surrounding structures. A mastoidectomy may be necessary to remove the growth and repair any damage it has caused.
Other conditions: Mastoidectomies may also be performed as a part of other surgeries to treat other conditions that affect the ear, such as acoustic neuroma (a benign tumor that grows on the auditory nerve) or congenital abnormalities in the ear.
The types of mastoidectomy are:
Simple or cortical mastoidectomy: This procedure involves the removal of the infected or diseased tissue from the mastoid bone, but does not involve any other major repairs or reconstructions.
Radical mastoidectomy: This procedure involves the removal of the entire mastoid bone and the middle ear, as well as the creation of a new opening in the eardrum to allow for better drainage.
Modified radical mastoidectomy: This procedure is similar to a radical mastoidectomy, but involves the removal of less of the mastoid bone and the creation of a smaller opening in the eardrum.
Canal wall-down mastoidectomy: This procedure involves the removal of the infected or diseased tissue from the mastoid bone, as well as the outer wall of the ear canal. This allows for better visualization and access to the middle ear and may be necessary in cases where the infection has spread to the ear canal or there are abnormalities in the small bones of the ear.
Canal wall-up mastoidectomy: This procedure involves the removal of the infected or diseased tissue from the mastoid bone, but leaves the outer wall of the ear canal intact. This may be appropriate in cases where the infection is limited to the mastoid bone and there are no abnormalities in the middle ear or ear canal.
After the procedure, the patient may need to take antibiotics to help prevent infection and may have to wear a bandage or dressing over the incision site.
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