Mastoidectomy

Ear infections in the space behind the ear drum (middle ear) often spread to the mastoid bone (the bone behind the ear). When patients have chronic ear drainage or perforations of the ear, bacteria have often involved the mastoid bone. The bacteria in the mastoid will often create biofilm which is a blanket of biological material that protects them from antibiotics. Oftentimes, patients get an infection and get antibiotics which stops the ear drainage but the infection returns a few weeks to months later. This return of infection is because the source of the bacteria in the mastoid remains and becomes active and re-creates the infection.

A mastoidectomy is performed to remove the disease (bacteria and biofilm) from the mastoid to allow the ear drum to heal as an adjunct to the tympanoplasty procedure. A mastoidectomy is also needed in patients with cholesteatoma to access the cholesteatoma.

The procedure itself is performed in the operating room. After you are put to sleep, your surgeon will make an incision behind your ear and into the mastoid tissue. The actual mastoidectomy portion of the surgery is 15 minutes. Since there are no nerve endings in the bone, there is very little pain from the mastoid itself. All discomfort for the operation is from the incision in the skin.

A mastoidectomy can be performed as canal wall up or canal wall down mastoidectomy. The canal wall up procedure is usually used when treating a hole in the ear drum. A canal wall down mastoidectomy and reconstruction of the mastoid is performed for patients with cholesteatoma.