Mastoidectomy or mastoidectomy is a surgical procedure performed to remove mastoid cells. Learn about mastoidectomy in Turkey in this article.
Surgery to resection and resection of the mastoid may be necessary when it extends Inflammation of the middle ear to the mastoid bone.
The most common condition is a dermoid sinus that grows from the outer ear to the middle ear, known as a cholesteatoma. It causes ear infection with secretions and impaired hearing ability. The sinus grows slowly, usually over many years, and gradually erodes the bony structures around it. Thus, erosion of the bone can lead to hearing loss. Mastoidectomy is the best treatment.
What is the mastoid bone?
The mastoid bone is the part of the temporal bone in the skull located just behind the ear. It is connected to the ear through the middle part (the middle ear) which is bounded by the tympanic membrane and contains the hearing ossicles (the hammer, the anvil and the stirrup). In the mastoid bone there are air cells that have grown gradually since birth and these cells have a role in the ventilation of the ear.
For whom is the mastoidectomy performed?
An infection or inflammation (infection) of the chronic middle ear, such as a cholesteatoma, can spread to the mastoid bone, causing mastoiditis and lead to pain, swelling, and redness in the mastoid bone behind the ear. This requires prompt treatment in a hospital, usually with antibiotics by Vein first and mastoidectomy if things don't improve as a next step.
If the condition is not treated well or is not detected early enough. Over time, this leads to the destruction of hearing and balance mechanisms and may cause facial paralysis and inflammation of the brain.
The most common reason for mastoidectomy surgery is a condition called cholesteatoma. It is a collection of dead skin cells that grow like a cyst from the tympanic membrane to the middle ear and mastoid bone. Over a few years, as this skin cyst grows, it can cause recurring inflammation (infection) in the ear.
The enlarged cyst may also begin to erode surrounding structures in and around the middle ear such as the small auditory ossicles (hammer, anvil, and stirrup) that transmit sound, the bony covering of the inner ear, the bones that protect the facial nerve and the rocky-ear bones in the skull that separate the ear from the brain.
This condition was initially diagnosed with hearing loss (loss), followed by a discharge from the ear that does not recover with topical or oral antibiotics. Therefore, the best treatment for cholesteatoma is mastoidectomy.
Sometimes it is made to be part of other operations such as the operation Cochlear implants.
How is the patient prepared for a mastoidectomy?
In the first place, the doctor will perform a comprehensive examination of the body, especially the nose, ear and throat. The sinuses and tonsils will be examined.
Your doctor will examine your ear using a portable otoscope. The microscope can be used to examine the ear more thoroughly and may be accompanied by suctioning the earwax to get a better view. This is a very safe procedure but can sometimes cause mild discomfort and dizziness. In addition, an audiogram will be done to check your hearing levels. Your consultant may order a CT scan or MRI.
Ear suctioning and treatment with inflammation medications will provide temporary relief from the disease. But the only safe and effective way to treat and remove cholesteatoma is to remove it with surgery.
What are the types of mastoidectomy?
Mastoidectomy surgeries are also known as combined tympanoplasty (CAT). There are different variations of the operation that are often tailored to the size of the cholesteatoma. There are several different approaches to performing mastoidectomy surgery:
In this procedure, the doctor removes the affected air cells.
What about radical mastoidectomy?
The doctor removes the mastoid cells, the eardrum, and most structures of the middle ear.
When undergoing modified radical mastoidectomy
Excision of infected cells in the mastoid with a few parts of the middle ear structures.
mastoidectomy below the canal wall
The lower and upper walls of the canal are excised and the meatus is augmented, leaving the eardrum in its place.
mastoidectomy above the canal wall
The upper and lower wall are left.
Excision of mastoid cells only without affecting the middle ear.
Therefore, you should discuss with your surgeon his or her preferred approach to mastoidectomy and what your condition requires.
What are the steps of mastoidectomy surgery?
Mastoidectomy is called combined method mastoidectomy and tympanoplasty (CAT), modified radical mastoidectomy, tympanostomy, tympanostomy or mastoid removal. These are just different methods with the same goals.
After a thorough clinical examination, the ENT surgeon will order an audiogram (audiogram) and a CT scan of the temporal bone and mastoid before proceeding with mastoidectomy. A mastoidectomy (removal of the mastoid process) is often performed under general anesthesia and takes between 1 and 4 hours.
Mastoidectomy involves making an incision above or behind the ear. Some surgeons may remove the mastoid through the auditory canal with the help of an endoscope (high-resolution) and a surgical microscope under high magnification, especially if the tumor is limited. Or the mastoid bone is opened with a high-speed drill to remove the temporal bone to access the tumor. Other techniques combined with endoscopy and laser may be used in mastoidectomy.
At the end of the procedure, a package will be placed in the ear to collect secretions during the recovery period. The package can be left for up to 3 weeks before being removed in the clinic. Some surgeons may use an absorbable pad that does not need to be removed.
As for the stitches, they can be removed after 7 to 10 days in the clinic by the doctor. After a mastoidectomy (removal of the mastoid process) there may also be a bandage on the head for up to 24 hours.
What are the alternatives to mastoidectomy surgery?
Surgery and mastoidectomy may not be the best option for the patient. This decision can be made with your surgeon. Regular ear cleaning with suction in the clinic and intermittent use of anti-inflammatory drops may contain infection but will not cure it completely. The risk of complications from an enlarged cholesteatoma will continue. These rare complications are meningitis (infection)/brain abscess, weakness of the facial nerves, dizziness, and complete hearing loss.
If your job involves swimming, requires the safety of the tympanum (such as jobs in the military), or depends on your natural sense of taste (the chef), mastoidectomy (removal of the mastoid process) can cause problems in your job and you should discuss this with your surgeon.
What are the complications of mastoidectomy?
There are many complications of mastoidectomy and here are the most important ones:
Taste disturbance after mastoidectomy
It is very common to experience a taste disturbance after a mastoidectomy. This is because the taste nerve is located close to the tympanic membrane and may be injured in rare cases during a mastoidectomy. This abnormal taste in the tongue occurs on the same side that was operated on. It is usually temporary but can sometimes be permanent.
Weakness in the facial nerves
There are rare complications of facial nerve dysfunction after mastoidectomy (resection). The facial nerve (the nerve that controls facial movement) passes through the mastoid bone and the middle ear. Sometimes the nerve becomes swollen after a mastoidectomy, but this is temporary and the facial movement will recover afterwards. But if the nerve is damaged, there may be permanent facial weakness.
Allergic reaction to the medicine in the ear pads: Some patients may have a skin reaction to the ear pads. If the patient feels itching or swelling in the ear, he should seek advice from the surgeon. Ear pads contain medicines that prevent infection.
Relapse after mastoidectomy
Relapse is very common. The risk is greater with disseminated cholesteatoma and may be related to the surgical technique used by the surgeon.
Hearing loss after mastoidectomy
Most patients have some degree of hearing loss before the operation. It's uncommon for you to lose your hearing completely after a mastoidectomy. But if the infection causes erosion of the inner ear (cochlea) or if your balance system is degraded, there is a higher risk of total and permanent hearing loss.
In some cases it is temporary but can last longer if the disease has damaged the balance organ.
You may already hear a noise (tinnitus) before the mastoidectomy, and in rare cases it may worsen after the mastoidectomy. You may continue to experience tinnitus, especially if you have a hearing loss.
What after mastoidectomy surgery?
Pain after mastoidectomy (resection) surgery is common, and you'll be given pain relievers to take home. This discomfort often lasts for up to two weeks.
You will have dressings in your ear and they are usually left in the ear for up to 3 weeks after your mastoidectomy surgery. You can expect a few spots of blood from the wound.
Stitches are removed 7 to 14 days after surgery. It is important to keep the ear dry during this period. After the mastoidectomy surgery, your doctor will give you a list of no-goes to stick to.
If you have any concerns about your mastoidectomy, contact us and we will refer you to the best otolaryngologist.
How long will I stay in the hospital after mastoidectomy?
Sometimes you can go home the same day, but be prepared for the possibility of an overnight stay in the hospital.
If there are risks after mastoidectomy (resection) surgery, you may need to stay in the hospital for a longer period.
What is the recovery period from mastoidectomy?
How quickly you recover depends on the type of mastoidectomy you have. You may be able to return to your normal life after two weeks, but you will need to keep the water away from the incision site and the ear. Most people recover completely after 6 to 8 weeks.
Follow-up after mastoidectomy
Patients are scheduled for an appointment a few weeks after the mastoidectomy. You may need long-term ear care after a mastoidectomy.
Before you give your consent, you should make sure you understand the benefits you will get from this surgical procedure, the risks (particularly those that may concern you a lot) and discuss any questions you may have with a specialist.
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