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The mastoid is a temporal bone of the skull that is located behind the ear. It contains a number of air spaces which connect to the middle ear. The ear comprises the outer, middle and inner ear.
Mastoidectomy is a surgical procedure that removes infected air cells of the mastoid bone (Mastoiditis). Mastoiditis is a serious bacterial infection that affects the mastoid bone usually caused by untreated acute otitis media (middle ear infection). It is more common in children and is a leading cause of child mortality.
You should visit the ENT physician if the child is suffering with any of the above symptoms or suffering with an infection that does not clear up with the treatment. Mastoiditis is diagnosed by examining the inner ear with otoscope. Some children may be advised a CT scan for detailed images of the skull.
A number of procedures have been described, such as simple, canal-wall-up and canal-wall-down mastoidectomy.
Simple mastoidectomy: The lateral wall of the mastoid is removed. The posterosuperior wall of the external acoustic meatus is preserved. The ossicular chain cannot be visualized.
Canal wall up (closed) mastoidectomy: Similar to a simple mastoidectomy in that the lateral wall of the mastoid is removed and the posterosuperior wall of the external acoustic meatus is preserved. Additionally, Koerner's septum is removed which grants access to the middle ear cavity and help visualize the first ossicle.
Canal Wall-Down (open) Mastoidectomy: Similar to a canal wall up mastoidectomy in that the lateral wall of the mastoid and Koerner's septum is removed to create a communication with the middle ear cavity. The main difference is that the posterosuperior wall of the external acoustic meatus is also removed. The tympanic membrane is usually reconstructed. A modified canal wall down mastoidectomy is similar but does not manipulate the ossicular chain of the tympanic membrane.
Intra Procedure: Mastoidectomy is performed under general anesthesia. Initially, a cut is made behind the ear to access the mastoid bone. Then using a microscope and a small drill, mastoid bone is opened. Once the bone is open, a suction irrigation is used to keep the surgical area free from the bone dust. Subsequently infected air cells are all drilled out and then operative site is stitched and covered with gauze.
Recovery typically takes 1-2 weeks and a break from school. An initial follow-up appointment should take place one week after surgery for suture removal, after which most normal activity can resume. Packing will be removed periodically as the ear heals.
Sometimes, following the mastoidectomy a minor skin graft procedure called "Thiersch grafting" is performed. This procedure involves removing a transparent layer of skin from the inside part of the upper arm and transplanted it over the surgical area insider the ear. This helps in the healing process and protects the ear from the infection.
This grafting is done in 10 to 30 days following the mastiodectomy. The patient is usually discharged from the hospital on following day of the surgery. Precautions to be followed after the surgery are:
As with the any other surgery mastiodectomy is also associated few risks and complications. General complications include:
Rare complications include:
BSR hospital is well-known for its team of expert and experienced surgeons with a proven track record of successful surgeries since the past 40 years. With a patient-centric approach to treatment, the doctors and the staff ensure, patient comfort and safety. The hospital offers quality treatment at affordable cost so that every patient can afford the treatment they deserve.
Using the latest technologies and equipment, BSR hospital provides safe treatment solutions and provides the necessary guideline for quick healing and recovery to all patients. The hospital is also backed by a complete range of diagnostic facilities for quick diagnosis and treatment, reducing the discomfort for the patient.