Mastoidectomy

The mastoid is a portion of the skull, that is situated behind the ear. The mastoid is filled with air cells that are made up of bone and appear like a honeycomb.
The diseased cells usually occur due to an ear infection that spreads into the skull. The procedure may also be performed to remove an abnormal ear growth, known as a cholesteatoma.

Types:
The different types of mastoidectomy procedures include:

1. Simple mastoidectomy: This procedure involves removing the infected air cells from the mastoid bone and draining the middle ear.
2. Radical mastoidectomy: This procedure involves the removal of the mastoid air cells, eardrum, most of the middle ear structures, and the ear canal.
3. Modified radical mastoidectomy: This procedure involves the removal of the mastoid air cells and some structures of the middle ear.

Symptoms

A mastoidectomy may be recommended in the following cases:

1. Cholesteatoma
2. Otitis media (middle ear infections)
3. Mastoid bone infection that does not go away using antibiotics 
4. Patients who want to place a cochlear implant (hearing device)

Symptoms:
The following symptoms may indicate the need for a mastoidectomy procedure:

1. Loss of hearing in one ear
2. Dizziness
3. Discharge from the ear
4. Feeling of pressure or fullness inside the ear
5. Swelling, pain, redness, and tenderness behind the ear
6. Pain inside the ear
7. Scaly skin around and in the ear
8. Fever
9. Headache 
10. Fatigue

Diagnosis

1. Physical examination: The overall physical health of the patient is evaluated by the doctor. The symptoms and medical history of the patient are also noted.
2. Otoscopy: The doctor will view the inside of the ear using a special tool known as an otoscope.
3. Blood tests: Certain underlying medical conditions can be diagnosed using this test.
4. X-ray of the skull: The bone defects in the skull can be detected using an x-ray.
5. CT scan: This is an imaging test performed to view the inside of the head and ear.
6. MRI scan: This is also a type of imaging test performed to obtain clear pictures of the head and the ear.
7. Audiometry: The hearing ability of a person can be evaluated using this test.
8. Culture of fluids drained from the ear: The fluid draining from the ear is evaluated to check for the presence of bacteria or other types of infections.

 

Treatment

• Mastoidectomy is generally done under general anesthesia, that is, the patient is put to sleep during the procedure.
• An incision or cut is made behind the affected ear.
• A bone drill is used to access the mastoid bone and middle ear cavity.
• In simple mastoidectomy, only the infected air cells from the mastoid bone are removed. 
• In radical mastoidectomy, the mastoid air cells, eardrum, most of the middle ear structures, and the ear canal are removed.
• In modified radical mastoidectomy, the mastoid air cells along with the back of the ear canal are removed.
• Removing the back of the ear canal may leave behind a cavity that allows easy access to the mastoid bone.
• If a cavity is created, it will be stitched using cartilage, which is a strong, elastic tissue that will make up the firm part of the ear.
• The cuts are then sutured and covered with a bandage.
• A drain may be placed behind the ear to prevent the accumulation of fluid.
• This type of surgery can be completed in two to three hours.

 

After Procedure

• Most patients go home one to two days after surgery.
• It is normal to experience some pain at the site of surgery, ear pressure, or headache after surgery. The doctor will recommend pain-relieving medications to relieve this discomfort.
• It is normal to have some soreness or stiffness in the jaw since it is in close proximity to the ear. The doctor will ask you to take soft food to prevent jaw pain.
• It is normal to hear popping or crackling noises in the ear after surgery.
• You may have some blood-stained from the ear for up to one or two weeks after surgery.
• You may experience altered taste following surgery.
• Some people may experience dizziness after the surgery for about one week.
• You may notice some difficulty in hearing for a couple of months after surgery due to dressing, swelling, or packing.
• Some patients may have numbness at the site of the incision for a couple of months after surgery.

Home remedies:

The following tips can help in a quick and smooth recovery after mastoidectomy:

• Sneeze with your mouth open. Avoid blowing your nose for a couple of weeks after surgery to prevent ear pressure buildup.
• Keep the surgical site clean and dry.
• Cover the ear using a shower cap while washing your hair.
• Change the cotton wool inside the ear canal when it becomes wet due to ear discharge.
• Use ear drops as prescribed by your doctor.
• You can resume going to work seven to ten days after surgery.
• Gentle activities like walking or doing household chores can be resumed approximately three weeks after surgery.
• Heavy lifting and strenuous activities should not be performed for four weeks after surgery.
• Avoid traveling by air for at least six weeks after surgery.
• Avoid swimming for at least eight weeks after surgery.
• Avoid driving or drinking alcohol while you are still taking painkillers.

Cost of mastoidectomy in India-

The cost of mastoidectomy in Mumbai is between INR 60,000 to INR 85,000.
The cost of mastoidectomy in Delhi is between INR 55,000 to INR 80,000.
The cost of mastoidectomy in Chennai is between INR 55,000 to INR 80,000.
The cost of mastoidectomy in Bangalore is between INR 50,000 to INR 75,000.