Information on Ear, Nose and Throat Surgeries      Mastoid Surgery - Mastoidectomy - Complications After Mastoidectomy
Complications After Mastoidectomy

A mastoidectomy for a cholesteatoma is a major surgery. 
Possible complications are discussed below:

  •  Hearing Loss.  Most patients will develop this.  The average conductive hearing loss after a mastoidectomy with removal of a cholesteatoma is 27 dB.  Often it is greater.  Remember the primary goal of the surgery is the complete removal of the cholesteatoma not preservation of hearing.  Rarely, the patient may lose all of his hearing.

  •  Chronic Draining Ear.  Some patients develop this. It should be remembered that unlike the drainage from a cholesteatoma this drainage is from superficial inflammation of the lining of the mastoid bowel and is rarely dangerous.  It sometimes develops if mucosa ( similar to the lining on the inside of the nose ) as opposed to skin lines the mastoid bowel.   Almost all patients who under go a canal wall down mastoidectomy will need to have their mastoid bowel cleaned every 6 to 12 months.   Daily irrigations with diluted white vinegar ( 1 part white vinegar to 4 parts water ) often helps to keep the mastoid bowel clean.  The mixture should be warmed to body temperature before irrigating or dizziness will be produced.

  •  The next three complications are unexpected but are encountered sometime in the carrier of most ENT Surgeons.  They often occur because the cholesteatoma has eroded into and already damaged the structures of the inner ear and lining of the brain.  Removal of the cholesteatoma is then the final straw which breaks the camel's back.  It left untreated, the cholesteatoma will eventually cause these same problems
    • Vertigo or dizziness
    • Facial Paralysis
    • Injury to the lining of the brain (Dura Mater).   This can cause a  cause a cerebral spinal fluid leak and meningitis.
  •  Meningitis, Stroke and Death --  Very rare complications.  These can also be caused by an untreated cholesteatoma.  
  •  The eardrum and ear bones may not be able to be reconstructed with can cause a worse than expected hearing loss.
  •  A fistula may also develop in the skin behind the ear.  
  •  The ear canal may close or narrow such that it cannot drain properly.  In canal-wall down operations, the mastoid cavity also has to drain through the ear canal.   Often a meatoplasty is used to enlarge the ear canal and prevent narrowing. 
  •  Skin Necrosis from the head dressing.   Many surgeons suggest wearing a head band or mastoid dressing to hold the external ear by the head, helping it to heal in the proper position.  It is very important not to have the headband too tight.  The head band is for tissue supoprt, comfort and to catch drainage.  It is not a pressure dressing. 

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