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Definition

A tympanomastoidectomy is a surgery to repair the middle ear. It includes repair of the eardrum and removal of damaged mastoid bone. The mastoid bone is the part of your skull that you can feel behind your ear.

The exact steps of the procedure will vary depending on your needs, but may include:

  • Repairing a hole in the eardrum (tympanoplasty)
  • Removing excess tissue behind the eardrum called cholesteatoma
  • Removing infected boney tissue
  • Repairing other damaged tissue
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Reasons for Procedure

Recurrent ear infections, tumors, or excess tissue growth can cause damage to the eardrum and surrounding tissue. A tympanomastoidectomy is done to repair the damage and if necessary remove damaged tissue.

A tympanomastoidectomy may be needed to:

  • Remove tumor or growth from the mastoid bone
  • Remove infected or excess tissue (such as a cholesteatoma) from behind the eardrum and surrounding area
  • Repair a hole in the eardrum
  • Repair hearing bones in the middle ear

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:

  • Infection
  • Reaction to anesthesia
  • Bleeding from the ear
  • Hearing loss
  • Dizziness or vertigo
  • Facial weakness or paralysis due to nerve damage
  • Repeat procedures

What to Expect

Prior to Procedure

You may meet with your doctor for a physical exam, medical history, and tests before the surgery. A doctor will use an otoscope to examine your ear.

Other tests may be done to evaluate your ear such as:

  • Hearing tests
  • CT scan
  • MRI scan

Before your procedure:

  • Avoid eating or drinking after midnight the night before.
  • Talk to your doctor if you take any medications, herbs, or supplements. You may need to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelet drugs

Arrange for a ride home and for someone to stay with you for the first night.

Anesthesia

Depending on the extent of the surgery, you may have:

Description of the Procedure

The surgeon will make an incision behind your ear. Any growths inside the mastoid will be removed. Infected bone tissue will also be removed. If a large part of the bone is removed, synthetic material may used to replace it.

The surgeon will then move to the eardrum. Any excess fluid will be drained out of the middle ear space. Holes of the eardrum can be repaired with by placing the new tissue over the hole in the eardrum. Excess scar tissue in the area will be removed. If necessary, the bones of the inner ear can be replaced with synthetic material. This helps improve or restore hearing.

Tubes may be left in place to help fluids drain from the ear. When all of the procedures are complete, the incision site will be closed.

How Long Will It Take?

2-3 hours

Will It Hurt?

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Post-procedure Care

At the Care Center

Right after the procedure, you will be in a recovery room. Your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

  • Pain medications
  • Antibiotics to prevent infection
  • Medication to prevent blood clots

At Home

It may take about a week or longer before you can fully return to normal activities. There may also be some muffled hearing. Certain activities will need to be avoided in the weeks after your procedure to prevent extra pressure on your ear. In the weeks after your procedure, your doctor may recommend that you:

  • Avoid heavy lifting or straining.
  • Sneeze with your mouth open and lightly blow your nose.
  • Keep water out of your ear. Avoid showers and washing hair until it is approved by the doctor.
  • Avoid swimming until doctor says it is OK to do so. Then limit swimming for several weeks.
  • Avoid flying until your doctor says it is okay.

Follow your doctor’s specific instructions during recovery to help healing.

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Increased fluid or foul-smelling fluid drainage from the ear
  • Redness, swelling, or increased pain in the ear
  • Bleeding from the ear
  • Dizziness, loss of balance, or vertigo
  • Pain that you can’t control with the medications you’ve been given
  • New or worsening problems with your ear

If you think you have an emergency, call for medical help right away.

Revision Information

  • American Academy of Family Physicians

    http://familydoctor.org

  • American Academy of Otolaryngology-Head and Neck Surgery

    http://entnet.org

  • Canadian Society of Otolaryngology

    http://entcanada.org

  • The College of Family Physicians of Canada

    http://www.cfpc.ca

  • Cholesteatoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 27, 2013. Accessed December 5, 2013.

  • Mastoidectomy and cholesteatoma. Society for Middle Ear Disease website. Available at: http://societyformiddleeardisease.org/SurgicalAtlasofPediatricOtolaryngology/5-Mastoidectomy-and-Cholesteatoma.pdf. Accessed December 5, 2013.

  • Tympanomastoidectomy. Midwest ENT website. Available at: http://mwent.org/surgical-info/tympanomastoidectomy.html. Accessed December 5, 2013.

  • Tympanomastoidectomy. Paparella Ear Head & Neck Institute, PA. Available at: http://www.pehni.com/patient%5Fed/tympanomastoidectomy.htm. Accessed December 5, 2013.

  • Tympanoplasty with ossicular chain reconstruction—surgical instructions. Head & Neck Associates of Orange County website. Available at: http://www.hnaoc.com/pdf/Surgery-Consents/tympanoplasty-with-ossicular-chain-reconstruction.pdf. Accessed December 5, 2013.