Mastoid Infection Treatment

Chronic ear infections can become more than a recurring inconvenience when they affect the middle ear, mastoid bone, or surrounding structures. For some patients, infection or abnormal tissue can extend into the mastoid air cells, the small air-filled spaces located in the skull bone behind the ear. When medication or less invasive care is not enough, mastoidectomy surgery may be recommended to remove diseased tissue, improve drainage, and help prevent ongoing infection.

At the Los Angeles Center for Ear, Nose, Throat and Allergy, we evaluate and treat chronic ear disease with a careful diagnostic approach. Our ear, nose, and throat doctors provide mastoidectomy in Los Angeles for patients with chronic otitis media, middle ear cholesteatoma, mastoid infection, and other conditions requiring specialized otologic surgery.

What Is a Mastoidectomy?

A mastoidectomy is the surgical removal of infected air cells within the mastoid bone. These air pockets are typically due to mastoiditis, ear infections, or other inflammatory conditions of the middle ear. When the bone becomes infected, it can lead to further complications, including facial paralysis.

The mastoid is the bone between the ear and the jaw. Recurrent and untreated ear infections can eventually spread to the bone which causes further discomfort and symptoms, including fever and swelling. Mastoiditis is most common in children and can be treated with antibiotics. In rare cases, surgery such as a mastoidectomy may be needed to remove infected bone. At LACENTA, we strive to provide the best Mastoidectomy Los Angeles has to offer.

What Can Mastoidectomy Treat?

Mastoidectomy is most often used to treat chronic ear disease that has not responded to medical treatment or has caused structural changes in the ear. It may be recommended for patients with:

• Chronic otitis media
• Chronic ear infections
• Mastoiditis or infected mastoid air cells
• Middle ear cholesteatoma
• Recurrent cholesteatoma
• Persistent drainage from the ear canal
• Ear pain related to chronic infection
• Hearing loss caused by middle ear disease
• Complications involving the mastoid bone or middle ear cavity

In some cases, mastoid surgery is performed to prevent infection from spreading or damaging nearby structures, including the facial nerve, inner ear, lateral semicircular canal, sigmoid sinus, or middle fossa floor. These areas are carefully protected during surgery.

Types of Mastoidectomy

The right surgical technique depends on the location and extent of disease, the condition of the ear canal and middle ear, hearing status, and the patient’s medical history.

Canal Wall Up Mastoidectomy

A canal wall up mastoidectomy removes diseased mastoid air cells while preserving the canal wall of the external ear canal. This approach can help maintain more normal ear anatomy, though some patients may need close follow-up or revision surgery if the disease returns.

Canal Wall Down Mastoidectomy

A canal wall down mastoidectomy removes part of the canal wall to create a larger mastoid cavity. This canal wall down procedure may be recommended for extensive disease, recurrent cholesteatoma, or cases where long-term access to the mastoid cavity is important.

Modified Radical Mastoidectomy

A modified radical mastoidectomy removes disease from the mastoid and middle ear while preserving as much hearing-related structure as possible. This technique may be used when infection or cholesteatoma involves both the mastoid air cells and middle ear space.

Radical Mastoidectomy

A radical mastoidectomy is less commonly performed today, but it may be necessary in select cases of severe or extensive disease. This procedure removes more middle ear and mastoid structures to create a safe, dry ear when preservation is not possible.

Benefits of Mastoidectomy Surgery

The main goal of mastoidectomy is to remove disease and help create a safer, healthier ear. Depending on the patient’s condition, mastoidectomy may help:

• Treat chronic ear infections that have not improved with medication
• Remove diseased mastoid air cells or cholesteatoma
• Reduce ongoing ear drainage or infection
• Prevent infection from spreading to nearby structures
• Improve access for future monitoring or treatment
• Support hearing preservation or reconstruction when possible

Hearing improvement depends on the cause of hearing loss and whether the middle ear bones, tympanic membrane, or inner ear have been affected. In some patients, the priority is controlling infection first, with hearing reconstruction considered separately.

Am I a Candidate for Mastoidectomy?

You may be a candidate for mastoidectomy in Los Angeles if you have chronic ear infections, chronic otitis media, cholesteatoma, persistent ear drainage, or mastoid infection that has not responded to nonsurgical treatment.

Before recommending surgical intervention, our team performs a complete evaluation. This may include an ear exam, review of symptoms, hearing testing, imaging, and video-recorded examination of the ear when appropriate. We also review prior ear surgery, history of drainage, balance symptoms, facial nerve symptoms, and any changes in hearing.

Mastoidectomy is typically considered when the risk of untreated disease is greater than the risk of surgery.

How Is Mastoidectomy Performed?

Mastoidectomy is typically performed under general anesthesia. An incision is made behind the ear so the surgeon can access the mastoid bone, and a bone drill is used to open the mastoid portion of the temporal bone and remove infected tissue, diseased mastoid air cells, or cholesteatoma.

The surgeon carefully works around important structures, including the facial nerve, inner ear, lateral semicircular canal, and surrounding soft tissue. Facial nerve monitoring may be used during the procedure to help reduce the risk of iatrogenic facial nerve injury or facial paralysis.

If the middle ear cavity is involved, additional repair may be performed during the same surgery. This may include work around the tympanic membrane, middle ear space, or tiny bones inside the ear. In some cases, mastoid obliteration may be considered to reduce the size of the mastoid cavity and support healing.

Recovery After Mastoidectomy

After mastoidectomy surgery, patients can expect mild discomfort, swelling, and a bandage around the ear during the immediate postoperative period. Some drainage, fullness, or temporary changes in hearing may occur as the ear heals.

Recovery instructions may include keeping the ear dry, avoiding heavy lifting, using prescribed ear drops or medication, and attending follow-up visits. These appointments allow our team to monitor healing, remove packing if needed, and check for signs of infection or recurrent disease.

Most patients return to light daily activities within a relatively short period, though full healing inside the ear can take longer. Patients who undergo a canal wall down mastoidectomy may need long-term mastoid cavity care to keep the ear clean and healthy.

Mastoidectomy Results

The results of mastoidectomy depend on the reason for surgery, the extent of infection or cholesteatoma, and whether the middle ear, mastoid bone, or hearing structures were affected. For many patients, the main goal is to create a safer, healthier ear by removing infected tissue, diseased mastoid air cells, or recurrent cholesteatoma. Some patients may notice less drainage, fewer infections, and improved ear comfort as healing progresses, while hearing outcomes vary based on the condition of the tympanic membrane, middle ear space, and tiny bones inside the ear. Follow-up care is an important part of monitoring healing and helping maintain long-term results.

Risks and Safety

As with any head and neck surgery, mastoidectomy has risks. These may include infection, bleeding, dizziness, taste changes, hearing loss, sensorineural hearing loss, facial nerve injury, cerebrospinal fluid leak, recurrent cholesteatoma, or the need for revision surgery.

Our physicians use careful surgical planning, appropriate imaging, and facial nerve monitoring when indicated to support safe outcomes. The specific risks depend on the extent of disease, anatomy, prior surgery, and the type of mastoidectomy performed.

Why Choose LA ENT for Mastoidectomy in Los Angeles?

Mastoidectomy requires detailed knowledge of ear anatomy, chronic ear disease, and otolaryngology head and neck surgery. At the Los Angeles Center for Ear, Nose, Throat and Allergy, our team provides comprehensive evaluation and treatment for patients with chronic otitis media, cholesteatoma, ear pain, hearing loss, and related ear conditions.

We focus on accurate diagnosis, appropriate surgical planning, and clear communication before and after treatment. Our goal is to help patients understand the condition, the recommended procedure, and what to expect from recovery.

Mastoidectomy FAQs

Is mastoidectomy major surgery?

Mastoidectomy is an ear surgery performed under general anesthesia. The extent of surgery depends on the patient’s condition, the amount of disease in the mastoid air cells, and whether the middle ear is also involved.

Will mastoidectomy improve my hearing?

Hearing improvement depends on the cause of hearing loss and the condition of the middle ear structures. Some patients may have better hearing after the disease is removed or reconstruction is performed, while others may need additional hearing treatment.

Where is the incision made?

The incision is usually placed behind the ear. This allows the surgeon to access the mastoid bone while keeping the incision in a less visible location as it heals.

What is the difference between canal wall up and canal wall down mastoidectomy?

A canal wall up mastoidectomy preserves the ear canal wall. A canal wall down mastoidectomy removes part of the canal wall to create a larger mastoid cavity, often for more extensive or recurrent disease.

Can cholesteatoma come back after mastoidectomy?

Yes, recurrent cholesteatoma can occur. Follow-up care is important after mastoidectomy, especially for patients with extensive disease or prior cholesteatoma.

How do I schedule an appointment?

To learn more about mastoidectomy in Los Angeles, patients can contact us at the Los Angeles Center for Ear, Nose, Throat and Allergy to request an evaluation with our ear, nose, and throat team.