Mastoidectomy

About Mastoidectomy

Mastoidectomy removes diseased mastoid air cells behind the ear, treating chronic otitis media with cholesteatoma, mastoiditis, and as access for cochlear implant insertion and skull base tumor approaches. Canal wall up CWU mastoidectomy preserves the posterior ear canal wall, maintaining normal anatomy but with higher cholesteatoma recurrence. Canal wall down CWD modified radical mastoidectomy removes the canal wall, creating a mastoid cavity that requires lifelong cleaning but provides better exposure and lower recurrence. The procedure involves a postauricular incision, drilling through mastoid cortex with identification of key landmarks tegmen, sigmoid sinus, facial nerve, lateral semicircular canal, and removal of diseased air cells. Cholesteatoma matrix must be completely removed to prevent recurrence. Tympanoplasty repairs the eardrum and ossicular chain. Complications include facial nerve injury, hearing loss sensorineural from inner ear trauma, dizziness, CSF leak, and taste disturbance chorda tympani nerve sacrifice. A planned second look operation or diffusion weighted MRI is often used to check for residual or recurrent cholesteatoma.