Chronic inner ear infection can sometimes result in an infection of a type of cell called mastoid air cells, which are located in the inner ear. Occasionally, this may in turn lead to an infection of the mastoid bone, which is also located in this area. When this occurs, it may be necessary to perform mastoidectomy surgery to correct the problem. This type of surgery involves the removal of infected mastoid cells from the inner ear, as well as infected mastoid bone.
In developed countries such as the United States, Canada, and the United Kingdom, otitis media and other ear infections are quickly and successfully treated with antibiotics. Mastoidectomy is no longer a common surgery in most developed countries; in developing countries, however, it is still a relatively common procedure. This is because untreated inner ear infections are more likely to result in the infection of mastoid air cells.
Mastoid air cells are located in the space behind the eardrum. This space is open and contains air as well as cells. Infection of this space can lead to infection of the mastoid bone, which can in turn lead to serious side effects. The most common of these is discharge from the ear. In more serious cases, ear and facial nerves can be damaged, leading to potential hearing loss, facial paralysis, and balance impairment.
During the procedure the patient is under general anesthetic. An incision is made behind or above the ear, through which infected cells and bone are removed. The procedure may take up to three hours, depending on how severe the infection is. There are multiple types of mastoidectomy.
The simplest form of the surgery involves the removal of mastoid cells only; no bone is removed, and the risk of hearing loss and other side effects is low. In a radical mastoidectomy, some of the mastoid bone must be removed from the inner ear. This procedure may also require the removal of other inner ear structures; therefore undergoing this operation can result in hearing loss. In a modified mastoidectomy, part or all of the mastoid bone is removed, and perhaps other middle ear bones as well. Tympanoplasty, a procedure which attempts to reconstruct the ear drum, is then performed to try and preserve hearing.
Many people can go home on the day the operation is carried out; however, full recovery often takes several weeks, however. Most patients will experience some mild discomfort following the procedure, but severe pain is uncommon and may indicate an infection. Possible side effects include dizziness or balance impairment, partial loss of hearing, infection, tinnitus, and facial muscle weakness. The extent of side effects is usually dependent on the extent of surgery, with radical surgery having a risk of more serious side effects.