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Tympanomastoidectomy

Definition

A tympanomastoidectomy is a surgery to remove abnormal or infected tissue in the bony area (mastoid) behind the ear. The eardrum is also repaired.

Normal Anatomy of the Middle Ear
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Reasons for Procedure

This surgery is done when repeat middle ear infections , tumors, or excess tissue growth has damaged the eardrum and surrounding tissue.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Facial weakness or paralysis due to nerve damage
  • Hearing loss
  • The need for repeat procedures

Things that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery, such as hearing and imaging tests

Anesthesia

The doctor may give:

Description of the Procedure

An incision will be made behind the 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 be used to replace it.

The eardrum will be removed. Any excess fluid will be drained out of the middle ear space. Holes of the eardrum can be repaired by placing 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. The incision will be closed with stitches. A bandage will be placed over the area.

How Long Will It Take?

2 to 3 hours

Will It Hurt?

Pain and dizziness are common in the first few days. It will be hard to hear at first, but hearing will improve with time. Medicine and home care can help.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Give you medicine to treat pain and lower the risk of blood clots
  • Encourage you to begin walking

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

It will take about a week for the incision to fully heal. Physical activity will be limited during this time to prevent extra pressure on your ear. You may need to ask for help with daily activities and delay your return to work.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, or discharge from the ear
  • Pain that you cannot control with medicine
  • Bleeding from the ear
  • Foul-smelling fluid draining from the ear
  • Dizziness or balance problems
  • New or unexpected symptoms

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

Resources

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

Canadian Resources

Canadian Society of Otolaryngology—Head and Neck Surgery
http://www.entcanada.org

The College of Family Physicians of Canada
http://www.cfpc.ca

References

Chronic suppurative otitis media (CSOM). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-suppurative-otitis-media-csom. Accessed September 28, 2021.

Tympanomastoidectomy. Kaiser Permanente website. Available at: https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.tympanomastoidectomy-what-to-expect-at-home.ud2603. Accessed September 28, 2021.

Tympanomastoidectomy: What is it and are you a candidate? Ear, Nose, Throat & Allergy Specialist website. Available at: https://ent-specialist.org/2020/08/14/tympanomastoidectomy-what-is-it-are-you-a-candidate. Accessed September 28, 2021.