Sound is passed from the eardrum through the middle ear bones to the inner ear, where the nerve impulses for hearing are created.
The middle ear is connected to the back of the nose and throat by the Eustachian tube, a narrow passage that helps to control the air flow and pressure inside the middle ear. The middle ear can become inflamed or infected when the Eustachian tube becomes blocked, for example, when someone has a cold or allergies. When fluid remains in the middle ear, the condition is called chronic serous otitis media.
Mastoidectomy: Procedure, Complications, and Outlook
Sometimes a middle ear infection causes a hole perforation in the eardrum. A hole that does not heal within six weeks is called chronic otitis media. This problem can take one of three forms:. Suppurative filled with pus chronic otitis media — This happens when there is a hole in the eardrum and an infection in the middle ear.
Cloudy and sometimes foul-smelling fluid drains out through the opening. Treatment with antibiotics usually helps to clear the active infection. Chronic otitis media with cholesteatoma — A persistent hole in the eardrum sometimes can lead to a cholesteatoma, a growth tumor in the middle ear made of skin cells and debris.
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A cholesteatoma also can form when there is no hole, but the Eustachian tube is blocked. Congenital cholesteatomas are present at birth and are not caused by a hole.
The exact cause is not known, but the eardrum is intact. Cholesteatomas can cause hearing loss and are prone to get infected, which can cause ear drainage. Cholesteatomas will grow large enough to erode the middle ear structures and the mastoid bone behind the middle ear. Children are more likely to get middle ear infections.
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Because of this, they also are more likely to develop chronic otitis media. Doctors believe that children have an especially high risk of all types of ear infections because of several factors, including: Problems with the middle ear, such as fluid in the middle ear, a hole in the eardrum, or injury to the small, middle ear bones, can cause hearing loss. In rare situations, infections in the middle ear can spread deeper inside the inner ear, causing a sensorineural hearing loss and dizziness.
Rare, but serious, complications include brain infections, such as an abscess or meningitis. A chronic infection and a cholesteatoma also can cause injury to the facial nerves and facial paralysis.
A person can have chronic otitis media caused by a persistent hole in the eardrum for years with no symptoms or only mild hearing loss. There may be mild ear pain or discomfort. When the middle ear is infected, fluid will drain from the ear and hearing loss can worsen. Symptoms that can be a sign of a more serious condition, and that require immediate attention, include:. The doctor will ask about a history of ear infections, treatments used, and any previous ear surgery.
The doctor also will want to know about any medications being taken to treat an ear problem, including the type, dose, and length of treatment. To confirm the diagnosis, he or she will look inside the ear with a special light called an otoscope and may take a sample of drainage fluid to be examined in a laboratory. In some cases, the primary care doctor may refer you or your child to an otolaryngologist, a doctor who specializes in treating disorders of the ears, nose and throat.
If the otolaryngologist suspects mastoiditis or a cholesteatoma, additional tests may be needed. If there is any concern that hearing may have been affected, it can be evaluated by a test called an audiogram. Your doctor usually performs a mastoidectomy using general anesthesia. For a simple mastoidectomy, your surgeon will usually:.
Chronic Otitis Media, Cholesteatoma and Mastoiditis
Your surgeon may also use a facial nerve monitor during surgery. This helps to limit injury to the facial nerve. You can expect to have bandages over your ear when you wake up. There will also be stitches close to your ear. You may have a headache, discomfort, and some numbness. You should avoid all strenuous activity for at least two to four weeks afterward, depending on your surgery. Also refrain from putting pressure on your ear.
Looking for doctors with the most experience performing mastoidectomy? Use the doctor search tool below, powered by our partner Amino. You can find the most experienced doctors, filtered by your insurance, location, and other preferences. Amino can also help book your appointment for free. Call your doctor if you experience any of these symptoms. You should also call your doctor if you have heavy ear bleeding or discharge, a fever over The outlook varies depending on the reason for the mastoidectomy and the type of mastoidectomy procedure. Some hearing loss is common with both modified radical and radical mastoidectomy.
You need to have regular follow-up appointments with your doctor if you had a cholesteatoma. At your post-operative follow-up, your doctor will check to make sure that your ear is healing correctly and that any complications are resolving. Identifying your triggers can take some time and self-reflection.
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