Mastoidectomy is an operation to remove disease from the bone behind the ear, when medical management is inadequate. There need not be drainage or ear pain for mastoid disease to exist. Sometimes a mastoidectomy is required in order to gain better exposure to the middle ear and attic. Although complications do not often occur, they include persistent ear drainage, infection in the mastoid cavity and hearing loss. Facial nerve injury (paralysis of the face on the side of the surgery) is a rare but potential hazard in mastoid surgery. There may be dizziness for a short time after surgery, but it is rarely permanent. Loss of taste on the side of the tongue usually lasts a few weeks but may be permanent.

Indications

1. History.. one or more required

a) Postauricular periosteal swelling or pain unresponsive to medical treatment.

b) Infected drainage from the ear unresponsive to medical treatment.

c) Planned second look for intact wall mastoidectomy.

d) Persistent middle ear disease unresponsive to management.

e) Fullness in the ear, hearing loss or pain.

f) Approach to failed tympanoplasty.

g) Evidence of chronic disease in patient who may not be aware of a problem such as retraction pockets with squamous debris, cholesteatoma, mucous crusts from non-infected discharge, and glomus tympanicum.

2. Physical Examination... required

a) Complete bilateral description of ear canal, tympanic membrane, postauricular area (if abnormal), facial nerve function and description of nystagmus (if present).

b) Evaluation of middle ear.

3. Tests

a) Audiometry-pure tone and speech bilateral.

b) Imaging-Mastoid X-Ray or CT scan.