Endoscopic Ear Surgery & Related Procedures
Tympanomastoid Surgery
Also known as tympanomastoidectomy, this surgical procedure is done to address conditions affecting both the middle ear (tympanum) and the mastoid bone, which is located behind the ear. This combined procedure is often necessary in cases where chronic middle ear infections or other conditions have spread to involve the mastoid cavity. It is one of many otologic microsurgeries which employs the use of a microscope or endoscope.
Indications
It is indicated in conditions like Chronic Suppurative Otitis Media (CSOM) where middle ear infections become persistent or recurrent with associated perforation of the tympanic membrane (eardrum) and involvement of the mastoid air cells; and Cholesteatoma - a benign but destructive growth of skin cells within the middle ear and mastoid, which can erode bone and potentially cause complications such as hearing loss, dizziness, or facial nerve weakness. Tympanomastoid surgery is recommended for complications of middle ear infections like mastoiditis (infection of the mastoid bone) or abscess formation within the mastoid cavity, which may necessitate surgical drainage and management.
During Surgery
The surgical procedure involves incision and exposure of the mastoid bone and middle ear structures. A mastoidectomy then removes diseased or infected mastoid air cells and bone to eradicate infection, improve drainage, and prevent recurrence. Different types of mastoidectomy may be performed based on the extent and severity of the disease (e.g. cortical mastoidectomy, canal wall up or down mastoidectomy). Next the tympanic membrane (eardrum) is repaired or reconstructed through tympanoplasty, if it is perforated or damaged. This may involve using graft materials to restore the integrity of the eardrum and improve middle ear function.
If the middle ear bones (ossicles) are damaged or eroded, they may be repaired or replaced with prosthetic devices to restore hearing. This procedure is called Ossiculoplasty. The surgeon also manages cholesteatoma by completely removing the cholesteatoma tissue to prevent recurrence and protect surrounding structures such as the facial nerve and inner ear.
After Surgery
Patients may require a hospital stay ranging from a few days to a week, depending on the extent of surgery and individual recovery. Antibiotics and pain medications are typically prescribed to prevent infection and manage post-operative discomfort. Regular follow-up visits are essential to monitor healing, assess hearing function, and address any complications that may arise.
