A tympanomastoidectomy is a surgery to repair the middle ear. It includes repair of the eardrum and removal of a damaged mastoid bone. The mastoid bone is the part of your skull that you can feel behind your ear.
The exact steps of the procedure will vary depending on your needs, but may include:
- Repairing a hole in the eardrum— tympanoplasty
- Removing excess tissue behind the eardrum called cholesteatoma
- Removing infected bony tissue
- Repairing other damaged tissue
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Reasons for Procedure
Recurrent middle ear infections, tumors, or excess tissue growth can cause damage to the eardrum and surrounding tissue. A tympanomastoidectomy is done to repair the damage and, if necessary, remove damaged tissue.
A tympanomastoidectomy may be needed to:
- Remove a tumor or growth from the mastoid bone
- Remove infected or excess tissue (such as a cholesteatoma) from behind the eardrum and surrounding area
- Repair a hole in the eardrum
- Repair hearing bones in the middle ear
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Reaction to anesthesia
- Bleeding from the ear
- Hearing loss
- Lightheadedness or vertigo
- Facial weakness or paralysis due to nerve damage
- Repeat procedures
What to Expect
Prior to Procedure
You may meet with your doctor for a physical exam, medical history, and tests before the surgery. A doctor will use an otoscope to examine your ear.
Other tests may be done to evaluate your ear such as:
Before your procedure:
- Avoid eating or drinking after midnight the night before.
- Talk to your doctor if you take any medications, herbs, or supplements. You may need to stop taking some medications up to one week before the procedure.
Arrange for a ride home and for someone to stay with you for the first night.
Depending on the extent of the surgery, you may have:
Description of the Procedure
An incision will be made behind your ear. Any growths inside the mastoid will be removed. Infected bone tissue will also be removed. If a large part of the bone is removed, synthetic material may used to replace it.
The eardrum will be removed. Any excess fluid will be drained out of the middle ear space. Holes of the eardrum can be repaired by placing new tissue over the hole in the eardrum. Excess scar tissue in the area will be removed. If necessary, the bones of the inner ear can be replaced with synthetic material. This helps improve or restore hearing.
Tubes may be left in place to help fluids drain from the ear. When all of the procedures are complete, the incision site will be closed.
How Long Will It Take?
Will It Hurt?
Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.
At the Care Center
Right after the procedure, you will be in a recovery room. Your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
- Pain medications
- Antibiotics to prevent infection
- Medication to prevent blood clots
It may take about a week or longer before you can fully return to normal activities. There may also be some muffled hearing. Certain activities will need to be avoided in the weeks after your procedure to prevent extra pressure on your ear. In the weeks after your procedure, your doctor may recommend that you:
- Avoid heavy lifting or straining.
- Sneeze with your mouth open and lightly blow your nose.
- Keep water out of your ear. Avoid showers and washing hair until it is approved by the doctor.
- Avoid swimming until doctor says it is okay to do so. Then limit swimming for several weeks.
- Avoid flying until your doctor says it is okay.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
- Signs of infection, including fever and chills
- Increased fluid or foul-smelling fluid drainage from the ear
- Redness, swelling, or increased pain in the ear
- Bleeding from the ear
- Lightheadedness, loss of balance, or vertigo
- Pain that you cannot control with the medications you were given
- New or unexpected symptoms
If you think you have an emergency, call for emergency medical services right away.
American Academy of Otolaryngology—Head and Neck Surgery
Family Doctor—American Academy of Family Physicians
Canadian Society of Otolaryngology—Head and Neck Surgery
The College of Family Physicians of Canada
Cholesteatoma. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115151/Cholesteatoma. Updated June 27, 2013. Accessed December 22, 2017.
Mastoidectomy and cholesteatoma. Society for Middle Ear Disease website. Available at: http://societyformiddleeardisease.org/SurgicalAtlasofPediatricOtolaryngology/5-Mastoidectomy-and-Cholesteatoma.pdf. Accessed December 22, 2017.
Tympanomastoidectomy. Midwest ENT website. Available at: http://mwent.org/surgical-info/tympanomastoidectomy.html. Accessed December 22, 2017.
Tympanomastoidectomy. Paparella Ear Head & Neck Institute, P.A. website. Available at: https://www.pehni.com/patient_ed/tympanomastoidectomy.htm. Accessed December 22, 2017.
Tympanoplasty with ossicular chain reconstruction—surgical instructions. Head & Neck Associates of Orange County website. Available at: http://www.hnaoc.com/docs/tympanomastoidctmy-w-ocr-june-2015.pdf. Updated September 2013. Accessed December 22, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 12/20/2014