A tympanomastoidectomy is a procedure mainly performed to clear a chronic infectious process of the middle ear and mastoid space. The mastoid process is the bony extension of the middle ear. It can be felt by pushing behind the auricle. Some chronic ear infections (so called cholesteatomas) can extend into this space and removal requires proper surgical access.
The procedure is usually performed as an outpatient surgery with optional overnight stay. For some more extensive cholesteatomas, overnight stay is preferred. Patients are asked to return for a postoperative clinic appointment one week after surgery. Further appointments will be required depending on the details of the surgical procedure performed.
In many cases, a second surgery will be required (so called second look procedure) about 6 to 12 months after the initial procedure. These surgeries are often necessary since cholesteatomas have a relatively high recurrence rate. Also, further reconstructive procedures can be performed during such second look procedures.
In other cases, the disease extent requires removal of the posterior canal wall separating the mastoid and the external ear canal. This creates a larger cavity requiring an enlargement of the ear canal opening (meatoplasty). Once this has been performed, frequent cleaning procedures will be required even once the linings have healed properly.
The risks of tympanomastoid surgery include those listed for other ear procedures, including facial nerve injury, disease recurrence, or inadequate hearing improvement. Often times, multiple surgical procedures are required and management of cholesteatomas can be a quite frustrating process for many patients.