A B C D E F G H I J K L M N O P R S T U V W

MASOIDECTOMY

What is a Masoidectomy ?

The ear drum separates the outer canal of the ear from the middle ear. Chronic suppurative otitis media is a condition in which infection of the middle ear persists or recurs repeatedly. The usually causes some permanent damage to the middle ear. In most cases a perforation of the eardrum is found. Some loss of hearing and discharge of fluid from the ear are usually present. Pain, noises in the ear (tinnitus) and giddiness (vertigo) may also occur in some people.

How does it occur ?

In most cases the patient will have had a previous acute ear infection which did not heal completely. In some people this results in a permanent hole in the ear drum.

Why does a Masoidectomy occur ?

A hole in the ear drum allows infection to get into the middle ear from the outer canal. This happens most often when water enters the ear. For example, when washing hair or swimming. If the hole is at the edge of the drum, it allows the outer skin of the drum to grow inwards. This process can produce a cyst in the ear called a cholesteatoma. When such a cyst is present, there is often also a fleshy swelling, called a polyp, growing through the hole the in the drum. The polyp grows whenever the ear is infected. However, if the hole is in the middle of the drum it is safe and does not usually cause a cyst.

What does treatment involve ?

Patients with a safe central hole in the drum can be treated without surgery. They can, however, have operations to close the hole (called tympanoplasty). This may improve hearing. Patients with a safe central hole in the drum who do not have surgery must not allow water to get in the ear. They can use large pieces of cotton wool smeared with vaseline to plug the ears when washing their hair. Swimming caps and ear plugs should ideally be used when swimming. Diving and swimming under water should be avoided. When there is a discharge of fluid from the ear, the ear is carefully cleaned. The doctor may also prescribe antibiotic drops to put in the ear. Patients with the unsafe type of disease with holes at the edge of the drum are usually offered surgery. MASTOIDECTOMY is the operation which is usually done for these cases. The purpose is to remove diseased tissue from the ear. It will create a safe ear which will no longer be a threat to life or health. It is usually necessary to be admitted to hospital for one day, and then be off work for a further 2 weeks. The operation is done under a general anaesthetic. Hair is sometimes shaved from around the ear. Through a surgical cut, bone is removed, together with the diseased tissue. This produces a cavity which can be kept clean from the outside. The cut is placed near to the ear and will usually have stitches which are removed later. The surgeon will usually pack gauze into the ear. This stays in position for 1 or 2 weeks. The operation itself is not very painful but may be followed by some giddiness. There is always some discharge from the ear after the operation. This is treated by local cleansing drops. Most ears become dry.

Possible complications of a Masoidectomy

Total loss of hearing is a very rare possibility. Damage to the facial nerve which passes through the ear can result in weakness of one side of the face. This is also a rare complication.

What if a Masoidectomy is not performed ?

The safe type of chronic suppurative otitis media is so-called because no serious problem would arise from not having an operation. Patients with the unsafe type of chronic middle ear disease risk developing a serious infection of the brain or nearby tissues. This is because the infection spreads.

After a Masoidectomy, what to expect

The bulky dressing and bandages on the ear will be reduced in size after one day. Pain is not severe and is easily relieved by ordinary painkillers. Giddiness is made worse by movement of the head, but again can be controlled by injections or tablets. The giddiness is not usually very bad and does not last for more than a few days. In the elderly, it may take rather longer to settle. Any gauze packing in the ear will be removed after a week or two. The removal of the gauze packing is usually done without the need for any anaesthetic. The ear needs to be kept dry and antibiotic drops may be prescribed. These drops should be kept at room temperature and placed in the ear with the head on its side. Most patients will be seen by the surgeon at regular intervals for care of the ear, including cleaning out the cavity. The hearing is usually reduced in the operated ear. After the operation of mastoidectomy, most patients will have worse hearing, which is permanent. This is the price that has to be paid to avoid the risk of spreading infection. In some cases, different types of mastoidectomy operation can be done, aimed at improving or preserving hearing. Most patients are able to return to work 2 weeks after surgery.