Mastoid Surgery

Mastoid surgery may be necessary when an ear infection within the middle ear extends into the mastoid bone. Most commonly this is a pocket of skin growing from the outer ear into the middle ear, known as cholesteatoma. This causes infection with discharge and some hearing loss. The pocket gets slowly larger, often over a period of many years, and causes gradual erosion of surrounding structures. Erosion of the ossicles can result in hearing loss.

What is the mastoid bone?

The mastoid bone is a part of the temporal bone located just behind your ear. It is connected to the ear through its middle part, which is bounded by your eardrum and contains the middle ear bones. The mastoid bone contains air cells that have gradually developed from birth and is postulated to have a role in ventilating the ear when you go up and down heights.

What problems can arise in the mastoid bone?

Infections or chronic middle ear conditions, such as cholesteatoma, can spread to the mastoid bone if poorly treated or not recognized early enough. Over time, these can result in destruction of the hearing and balance mechanisms and even give rise to facial paralysis and brain infections.

What are the symptoms to be aware of?

Mastoid infections (termed mastoiditis) usually present with a prolonged middle ear infection that results in pain, swelling and redness to the bone behind the ear. Occasionally, the ear can be propped forward and there may be a boggy swelling. This usually requires prompt in hospital treatment, usually with intravenous antibiotics first and surgery should things not improve.

Chronic middle ear conditions such as chronic otitis media and cholesteatoma are slow growing and may present initially with hearing loss followed by an ear discharge that does not settle with topical or oral antibiotics. The treatment of choice for cholesteatoma is surgery.

If you are concerned you have these, you should speak to your GP and request for a referral to an ENT surgeon.

What does surgery involve?

After a thorough clinical history and examination, your ENT surgeon will usually request for a hearing test (audiogram) and CT scan of the mastoid bone before proceeding to surgery.

The operation can be done as a day case operation under general anaesthetic and would usually take anywhere between 1 and 4 hours. An incision is usually made in front or behind the ear to access all aspects of the outer, middle and inner ear as well as the mastoid bone. The surgery is usually performed using a combination of high-definition endoscopes and an operating microscope under high magnification. A high-speed drill typically used to remove the bone to get access to the disease

At the end of surgery, patients may wake up with a head bandage around their head and packing material within their ear.

Mastoid surgery may be referred to as Combined Approach Tympanoplasty (CAT), Modified Radical Mastoidectomy, Atticotomy, Atticoantrostomy or Tympanomastoid surgery. These are merely different approaches that all have the same aims to remove the disease safely with the preservation of hearing.

Your ENT surgeon will spend time going through all the different options with you.

What is the recovery time?

Patients will be able to go home after 2-3 hours of the procedure and can remove the head bandage themselves the next day. It is advisable to have 2 weeks off work.

Your ENT surgeon would usually arrange to see you in 2 weeks to remove any packing material from your ear.

Need Help?

At One Hatfield Hospital in Hertfordshire, we can book you in to specialist surgeon, usually within 48 hours, for an initial consultation to discuss the diagnosis and treatment of your symptoms and, if necessary, gallbladder removal surgery.

You can use your private medical insurance or pay for your Mastoid Surgery treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Hatfield Hospital.

Why One Hatfield

• Modern purpose-built hospital opened in December 2017
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• Private, spacious, en-suite rooms
• Specialist physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

Contact us and find out more

If you are based in and around Hertfordshire, St Albans, Stevenage, Watford, North London, Welwyn or Bedfordshire and would like to visit the One Hatfield Hospital please click here.