Overview
Mastoidectomy is a surgical procedure to remove diseased mastoid air cells, commonly performed for cholesteatoma or chronic otitis media.
Mastoidectomy is crucial for treating cholesteatoma, chronic mastoiditis, and preventing intracranial complications.
Learn more in our comprehensive RxDx ENT Course
Indications
Acquired or congenital
Persistent infection
Intracranial complications
Facial nerve palsy
Cochlear implantation
Contraindications
Absolute Contraindications
Relative Contraindications
📋 Equipment Checklist
Check off items as you gather them:
Pre-procedure Preparation
Preparation includes patient assessment, imaging review, equipment setup, and understanding contraindications.Step-by-Step Procedure
Step 1: Patient Preparation
Position patient, administer anesthesia.
⚠️ Common Mistakes to Avoid:
- Poor positioning
- Inadequate anesthesia
💡 Pro Tip:
Use proper positioning.
Step 2: Incision
Make postauricular incision.
⚠️ Common Mistakes to Avoid:
- Wrong incision
- Poor exposure
💡 Pro Tip:
Use proper technique.
Step 3: Mastoid Exposure
Expose mastoid bone.
⚠️ Common Mistakes to Avoid:
- Inadequate exposure
- Tissue damage
💡 Pro Tip:
Use gentle technique.
Step 4: Mastoidectomy
Remove diseased mastoid air cells.
⚠️ Common Mistakes to Avoid:
- Incomplete removal
- Facial nerve injury
💡 Pro Tip:
Use careful technique.
Step 5: Cavity Obliteration
Obliterate mastoid cavity if needed.
⚠️ Common Mistakes to Avoid:
- Poor obliteration
- Recurrence
💡 Pro Tip:
Use proper technique.
Step 6: Closure
Close incision and pack ear canal.
⚠️ Common Mistakes to Avoid:
- Poor closure
- Inadequate packing
💡 Pro Tip:
Use proper technique.
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Post-procedure Care
Post-procedure care involves wound care, monitoring for complications, and long-term follow-up.Complications & Management
| Complication | Incidence | Signs | Management | Prevention |
|---|---|---|---|---|
| Facial nerve injury | 1-3% | Facial weakness | Monitoring, rehabilitation | Careful technique |
| Hearing loss | 5-15% | Worsened hearing | Hearing aids | Gentle technique |
| Infection | 2-5% | Wound infection | Antibiotics | Sterile technique |
| Recurrence | 5-10% | Recurrent disease | Revision surgery | Complete removal |
Clinical Pearls
Use facial nerve monitoring.
Identify key landmarks.
Remove all diseased tissue.
Inspect for residual disease.
Document procedure details.
Provide clear post-op instructions.
Monitor for complications.