Mastoidectomy and Tympanomastoidectomy

Mastoidectomy opens the honeycomb of air cells in the mastoid bone behind the ear to remove disease. The usual reason is cholesteatoma, a pocket of trapped skin that grows behind the eardrum and slowly erodes bone. When the eardrum and hearing bones are repaired in the same operation it is called tympanomastoidectomy.

The first aim is a safe, dry ear; better hearing is a secondary goal and not always possible. Cholesteatoma can be left behind or come back, so follow-up for years is part of the treatment.

What Mastoidectomy and Tympanomastoidectomy involves

Under general anaesthetic a cut is made in the crease behind the ear and the ear is folded forward. Working under a microscope with a high-speed drill and constant irrigation, the surgeon removes mastoid air cells to follow the cholesteatoma sac from the attic back into the mastoid, keeping clear of the facial nerve, the balance canals and the lining of the brain. The sac is removed intact where possible. The eardrum is rebuilt with cartilage and fascia, and eroded hearing bones are bridged with reshaped bone or a titanium prosthesis, either now or at a planned second stage. The wound is closed and the canal packed.

Who is a good candidate for Mastoidectomy and Tympanomastoidectomy?

Surgery is the only effective treatment for cholesteatoma and is advised for almost everyone fit for anaesthesia.

• Cholesteatoma confirmed on examination and CT
• Chronic discharging ear with mastoid disease not controlled by drops and cleaning
• Complications of ear infection such as mastoid abscess
• As the access route for cochlear implantation or some inner ear surgery

Es ist normalerweise nicht die richtige Wahl, wenn:

• A dry central perforation without cholesteatoma, which needs only tympanoplasty
• People unfit for general anaesthetic, who may be managed by regular microsuction
• The only hearing ear, unless the disease is a clear danger, and then by a very experienced surgeon
• Anyone unable to attend follow-up over several years

Technikoptionen

• Canal wall up mastoidectomy: Keeps the ear canal wall, giving a normal-looking ear that tolerates water. Higher chance of residual disease, so a second look or MRI follow-up is planned.
• Canal wall down mastoidectomy: Removes the canal wall to create an open cavity. Lower recurrence, but the cavity needs lifelong cleaning and may not tolerate water.
• Mastoid obliteration: The cavity is filled with bone dust, cartilage or a muscle flap to avoid cavity problems.
• Endoscope-assisted removal: Angled scopes check hidden recesses to reduce residual cholesteatoma.
• Ossiculoplasty: Rebuilding the hearing bones, done at the same time or as a second stage after 9 to 12 months.

Was passiert während Ihrer Behandlung

The operation lasts 2 to 4 hours. You wake with a head bandage for a day and packing in the ear canal, so hearing on that side is dull. Pain is moderate and controlled with tablets. Short-lived dizziness and an odd taste are common. Expect 1 or 2 nights in hospital.

Vorbereitung auf Ihre Reise

Plan for 10 to 14 days; up to 3 weeks if packing is removed before you leave in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stoppen Sie das Rauchen und Nikotin mindestens vier Wochen vor und nach der Operation; es ist die größte vermeidbare Ursache von Wundproblemen
• Erzählen Sie dem Team von allen Medikamenten und Ergänzungen, die Sie einnehmen; Blutverdünner, einige Kräuterprodukte und Hormonbehandlungen müssen möglicherweise auf Anraten Ihres Arztes unterbrochen werden
• Vereinbaren Sie, dass jemand mit Ihnen reist oder erreichbar ist, und halten Sie die ersten Tage zu Hause frei von Arbeit und Heben
• Buchen Sie einen veränderlichen Rückflug; Ihr Chirurg bestätigt, wenn Sie fit sind

Genesung und Ergebnisse

Stitches are removed or dissolve at about a week. Keep the ear completely dry. Packing is taken out at 2 to 3 weeks; plan for that visit or arrange it at home. Take 2 weeks off work, longer for manual jobs. Flying is normally permitted after 2 to 3 weeks if the hearing bones were not reconstructed with delicate prostheses, but follow your surgeon's advice. A hearing test is done at 2 to 3 months. Follow-up includes either a second-look operation or a diffusion-weighted MRI at about a year.

• Zurück zur alltäglichen Aktivität: 2 Wochen
• When results show: Dry ear in 6 to 8 weeks; hearing assessed at 3 months
• How long they last: Long-term, with surveillance for recurrence

Sicherheit, Risiken und Revisionspolitik

The mastoid contains the facial nerve, the inner ear and the floor of the skull, so rare complications can be serious.

• Residual or recurrent cholesteatoma
• Hearing unchanged or worse, and rarely total loss in that ear
• Persistent discharge, especially from an open cavity
• Dizziness, usually temporary
• Taste disturbance from the nerve crossing the middle ear
• Facial nerve weakness, rare in primary surgery
• Tinnitus
• Leak of brain fluid or meningitis, which is very rare

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Mastoidectomy and Tympanomastoidectomy in Türkiye

Clinic-Y does not publish a single price for Mastoidectomy and Tympanomastoidectomy, because the honest figure depends on your case. What moves it:

• Canal wall up versus down, and whether obliteration is done
• Operating time and facial nerve monitoring
• Hearing bone prosthesis
• CT and MRI imaging
• Planned second-stage surgery

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