Mastoidectomy is a fairly frequent procedure performed for a variety of temporal bone pathologies including mastoiditis and cholesteatoma. It involves removing part of the bony wall of the mastoid to aid in drainage and/or surgical excision.
Types of mastoidectomy
A number of procedures have been described, commonly divided into simple, canal wall up and canal wall down mastoidectomy.
The lateral wall of the mastoid is removed. The posterosuperior wall of the external acoustic meatus is preserved 1. The ossicular chain cannot be visualised.
Canal wall up (closed) mastoidectomy
Similar to a simple mastoidectomy in that the lateral wall of the mastoid is removed and the posterosuperior wall of the external acoustic meatus is preserved 1. Additionally Koemer's septum is removed which grants access to the middle ear cavity and visualises the ossicles 1.
Canal wall down (open) mastoidectomy
Similar to a canal wall up mastoidectomy in that the lateral wall of the mastoid is removed and Koemer's septum is removed creating a communication with the middle ear cavity 1. The main difference is that the posterosuperior wall of the external acoustic meatus is also removed 1. The tympanic membrane is usually reconstructed.
A modified canal wall down mastoidectomy, is similar but does not manipulate the ossicular chain of tympanic membrane.
Some of the more common complications include: