MastoidectomyBy: Shay Praag

What is it?Removal of part of the mastoid bone when medical assistance is needed. A Mastoidectomy is only done if antibiotics have been tried and aren’t working.Done when there is a cholesteatoma, skin cyst in middle ear.

Simple MastiodectomyOnly infected air cells are removed

Radical MastoidectomyRemove almost all of the bone.

Tympanic Membrane and middle ear bones are removed.

Stapes if spared if possible.

Exposing the Mastoid Bone

Anesthesia, Position, Prep, DrapeLocal, Supine with donut under head, Shave if Surgeon prefers, restrain hair with tape, hairline to shoulder to middle of face, drape with 3-4 sterile towels, cover head with disposable drape, place 2 towels at neck.

Instruments and Supplies

Ear Instrument setCutting burs Suction Irrigator Instruments to take small skin graft

Prep setBasin setHead and Neck packMicroscope drapeGel FoamSuture (SP)Dressing (SP)

Procedure Steps:1. Inject ear with local. Get skin graft prior to ear prep and draping.2. Make incision behind ear.3. Harvest temporalis fascia.4. Drill mastoid bone. Use suction irrigator to suction plume and bone fragments and to prevent charring of bone. 5. Surgeon removes ossicles at this point.

6. Use Rosen needle to remove cholesteatoma.7. Surgeon places fascia graft8. Cut Gelfoam into squares to pack mastoid.9. Close with absorbable suture.10. Skin closed with 4-0 11. Pack external canal.12.Fluffed gauze placed around ear.