Mastoidectomy in Turkey: Professional Otologic Surgery in Istanbul

How Mastoidectomy Treats Chronic Ear Infection ?

Cholesteatoma, a benign skin growth in the middle ear, expands slowly and erodes bone if untreated. Antibiotics alone cannot eliminate it. Mastoidectomy surgically removes the diseased mastoid air cells and the cholesteatoma itself, preventing serious complications like meningitis, facial paralysis, or permanent hearing loss.

The surgery is less common today than decades ago because early antibiotic intervention catches most infections before they spread to bone. However, once bone erosion occurs (confirmed by CT imaging),surgical removal becomes necessary. Delaying increases infection risk and complicates future reconstruction.

Recovery involves temporary ear drainage and mild discomfort, managed with prescribed antibiotics and regular ear cleaning. Most patients resume normal activities within 2 to 3 weeks, though strenuous exercise waits 4 to 6 weeks.

Mastoidectomy for Chronic Otitis Media Complications

Chronic otitis media, a persistent middle ear infection, can lead to mastoiditis when bacteria spread into the mastoid bone. This progression causes bone erosion, hearing loss, and risk of intracranial infection. Mastoidectomy removes infected air cells and prevents these life-threatening complications.

Patients often experience years of ear drainage, conductive hearing loss, and recurrent infections before seeking surgery. Imaging (CT scan) confirms bone involvement and guides surgical planning. The procedure combines infection removal with middle ear drainage, reducing recurrence risk to under 8%.

Post-operative care includes ear precautions (keeping water out during bathing) for 2 to 3 weeks and follow-up audiometry to assess hearing improvement. Many patients report relief from chronic ear pain and drainage within days of surgery.

Types of Mastoidectomy: Canal Wall Up vs. Down

Two main surgical approaches exist, each with distinct outcomes. Canal Wall Up (CWU) mastoidectomy preserves the ear canal, reducing post-operative drainage and water precautions. Success rates for infection control reach 90 to 94%, though cholesteatoma recurrence risk is higher (around 16%) than canal wall down techniques.

Canal Wall Down (CWD) mastoidectomy widens the ear canal by removing part of the canal wall, creating a common cavity. This approach has a lower cholesteatoma recurrence rate (around 7%) but requires lifelong water precautions and may cause chronic drainage in 10 to 15% of patients. Hearing outcomes differ: CWU preserves better ossicular function, while CWD may worsen conductive hearing loss.

Your surgeon selects the approach based on disease extent, age, hearing status, and patient preference. Younger patients often prefer CWU despite slightly higher recurrence risk. Revision surgery is possible if recurrence occurs after CWU.

Mastoidectomy Procedure Steps in Istanbul Turkey

Before surgery: Stop aspirin and blood-thinning medications 7 to 10 days prior. Fasting begins at midnight the night before. Pre-operative imaging (CT, audiometry) confirms diagnosis and guides surgical planning. Anesthesia consultation assesses overall health and medication interactions.

During the procedure: General anesthesia is induced. The surgeon makes an incision behind the ear, exposing the mastoid bone. Using a drill and microscope (or endoscope),diseased air cells are carefully removed. The middle ear is inspected and drained. Ossicles (tiny ear bones) are assessed for erosion or reconstruction need. The incision is closed with absorbable sutures.

After surgery: Patients wake in recovery with ear bandages and possible ear packing (removed after 1 to 2 weeks). Pain is mild to moderate, managed with prescribed analgesics. Ear drainage is normal for 2 to 3 weeks. Activity restrictions include no water in the ear, no strenuous exercise for 4 to 6 weeks, and head elevation while sleeping to reduce swelling.