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Medical Disability Advisor  >  Mastoidectomy

Mastoidectomy


Related Terms


  • Modified Radical Mastoidectomy
  • Simple Mastoidectomy
  • Tympanoplasty Radical Mastoidectomy

Specialists


  • Anesthesiologist
  • General Surgeon
  • Infectious Disease Internist
  • Neurologist
  • Occupational Therapist
  • Otolaryngologist
  • Physiatrist
  • Physical Therapist

Comorbid Conditions


  • Cardiovascular disease
  • Respiratory disorders

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Factors Influencing Duration


Duration of disability may be affected by the severity of the underlying condition requiring treatment, type and extent of procedure, individual response to treatment, and existence of complications.

Medical Codes


ICD-9-CM:
20.4 - Mastoidectomy
20.41 - Mastoidectomy, Simple
20.42 - Mastoidectomy, Radical
20.49 - Mastoidectomy, Other; Atticoantrostomy; Mastoidectomy NOS; Modified Radical Mastoidectomy

Definition


A mastoidectomy is the surgical removal of all or part of the mastoid bone at the side of the skull directly behind the ear.

A mastoidectomy is done to treat the effects of the spread of an infection into the various parts of the mastoid process from the middle ear. The mastoid process consists of several porous or honeycomb-like areas and is part of the temporal bone that lies behind the ear. Mastoiditis is an inflammation of any part of this structure due to infection. However, mastoiditis almost always results from acute or chronic ear infection (otitis media). At one time, mastoiditis was a very serious and dangerous disease. Due to use of antibiotics, it is now quite uncommon. Before antibiotics, mastoiditis was one of the leading causes of death in children. Mastoiditis is a relatively uncommon disorder, although it can occur in adults.

Another reason for the procedure may be linked to occasional development of an active infection causing the skin of the ear canal to grow through a hole in eardrum. A skin-lined cyst called a cholesteatoma may be formed when the infection passes into the middle ear and the mastoid bone. These may occur because of chronic otitis media. When these conditions occur, a radical mastoidectomy may be necessary. Several operations of varying scope and intensity may be required over a long period of time to fully remove infections and their effects. The initial operation is a mastoidectomy with rebuilding of the eardrum (tympanoplasty). The final stage of this sequence of operations may be a radical mastoid obliteration operation. When this becomes necessary, improvement or restoration of hearing is not considered.

Source: Medical Disability Advisor



Reason for Procedure


A revision mastoidectomy operation may be used to eliminate any discharge from a mastoid cavity defect that has been created and, if possible, to improve the hearing. A modified radical mastoidectomy may be necessary to eliminate infection in individuals with a very resistant infection or who have infections in an only hearing ear. Finally, a mastoid obliteration operation may be needed to eliminate any mastoid infection and to obliterate or fill any created mastoid cavity. Hearing improvement is not usually considered in the two latter operations.

Source: Medical Disability Advisor



How Procedure is Performed


A mastoidectomy is usually done under general anesthesia.

Entry is made through the ear canal or from behind the ear. In a simple mastoidectomy, infected bone cells are removed. The eardrum is cut to drain the middle ear. Antibiotics are then placed in the ear, intravenously, or by mouth.

In a radical procedure, the eardrum and most middle ear structures are removed. After surgery a hearing aid may be used. In a modified radical procedure, some middle ear bones are left in place and the eardrum is rebuilt (tympanoplasty).

The incision is closed with sutures, and a dressing is applied.

Source: Medical Disability Advisor



Prognosis


The outcome is generally excellent for infection control, although additional surgery is occasionally needed to address new pockets of infection or provide refinements in hearing once infection has been cleared. Useful hearing is often achievable.

A radical or modified radical mastoidectomy usually results in less than normal hearing.

Source: Medical Disability Advisor



Complications


Complications are rare, but may include nerve damage to the face, dizziness, hearing impairment, taste disturbances, and infection. Mastoiditis may recur.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Heavy lifting or work that requires exertion should be restricted, since it may damage the supporting structure of the inner ear and slow healing. Since the individual may be dizzy for several days following the procedure, advice should be given to avoid piloting an airplane or driving a car until dizziness has completely disappeared. When a radical mastoidectomy has been performed, dizziness may persist for several months.

Source: Medical Disability Advisor



General References


"Mastoiditis." eCureMe. 21 May 2005 <http://www.ecureme.com/emyhealth/Pediatrics/Mastoiditis.asp>.

Source: Medical Disability Advisor






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