Mastoidectomy and Meatoplasty

Mastoidectomy and meatoplasty are types of ear surgery. Mastoidectomy removes part of the mastoid bone (the large bone behind the earlobe). It may be done if tiny air cells in the bone become infected or damaged. These problems can increase the risk of ear infections and hearing loss. Meatoplasty makes the opening into the ear canal (meatus) larger. It may be done after mastoidectomy to make it easier to check and clean the ear.

Preparing for Surgery

Prepare for the procedure as you have been instructed. Be sure to tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs and other supplements. You may need to stop taking some or all of them before surgery. Also, follow any directions you’re given for not eating or drinking before surgery.

The Day of Surgery

The surgery takes about 1-3 hours. You’ll likely go home on the same day. Before the surgery begins:

• An IV line is put into a vein in your arm or hand. This line supplies fluids and medications.

• To keep you free of pain, you’re given general anesthesia. This medication puts you into a state like deep sleep through the surgery.

During mastoidectomy:

• An incision is made behind the ear or in the ear canal.

• The mastoid bone is exposed. The bone is then opened with a special drill. Great care is taken to avoid harming the facial nerve, which runs from the brain through the bone. This nerve controls facial movement. A special device may be used to map the exact location of this nerve, to help avoid damaging it.

• Suction, water, or saline fluid may be used to remove bone dust and to cool nearby tissues.

• The diseased or damaged air cells in the mastoid bone are removed.

• The bony wall between the ear canal and mastoid bone may also be removed.

• Some of the bones in the middle ear may be removed as well. These bones help with hearing. To maintain or restore hearing, the bones are replaced (either with donor or artificial bone, or with a prosthetic). This may be done during the surgery. Or a second surgery may be needed to perform this repair at a later date.

• If needed, the eardrum is repaired. This is often done with tissue taken from the incision behind your ear.

During meatoplasty: Incisions are made in and around the ear canal. Then tissue is removed or rearranged to make the ear opening larger.

When both procedures are finished:The ear canal will be filled with antibiotic ointment or fluid. This helps prevent infection. Packing (a special kind of dressing) may also be placed in the ear canal. Any incisions made are closed with stitches. A sterile bandage may then be placed over the ear.

After the Surgery

You’ll be taken to a room to wake up from the anesthesia.You’ll be given medications to manage pain and prevent infection. If you have packing inside the ear canal, you may have trouble hearing out of that ear. This is not a sign of a problem. Be aware that you may have some dizziness after the surgery. This can last for a few days. When it’s time for you to be released from the hospital, have an adult family member or friend ready to drive you.

Recovering at Home

Once at home, follow any special instructions you are given. Make sure to:

• Take all medications as directed. These may include ear drops and ear ointment.

• Care for your incision and packing as instructed.

• Place a cotton ball dabbed with a small amount of petroleum jelly in the outer ear before you bathe or shower. This helps keep your ear dry. Remove the cotton ball when you’re done bathing or showering.

• Avoid driving, climbing stairs, and standing on ladders until any dizziness has passed.

• Avoid heavy lifting and strenuous activities for at least 2 weeks

• Avoid swimming, flying in a plane, or traveling in the mountains until your doctor says it’s okay.

Follow-Up

During follow-up visits, your doctor will check your healing. If your stitches or packing need to be removed, this may be done in about 7-10 days. You and your doctor can also discuss any further treatments or surgeries that may be needed. Going forward, you’ll need regular visits with your doctor to have your ear checked and cleaned. If the bony wall between the ear canal and mastoid bone was not removed, you’ll have a permanent mastoid cavity that needs to be cleaned by a doctor. And you’ll need to take extra care to avoid getting water in your ear, which can increase your risk of infections.