ENT SURGERY
Mastoidectomy
The mastoid bone behind the ear contains honeycomb-like air cells. When infection or abnormal tissue growth spreads here, antibiotics cannot resolve it. Left untreated, it can cause meningitis, brain abscesses, and permanent hearing loss.
A mastoidectomy is a crucial ENT surgery that removes these diseased air cells, clears infection, and eliminates cholesteatoma (abnormal skin growth). This procedure protects patients from chronic ear disease and life-threatening intracranial complications.
At Royal Eye & Ear Hospital, our ENT specialist performs mastoidectomies with the high precision and expert post-operative care this delicate surgery requires.
How It Works
Mastoidectomy involves Five precise steps:
- 1.General anaesthesia — The operation is almost always performed under a general anaesthetic. You are completely asleep and feel nothing throughout the procedure.
- 2.Surgical access — Cuts will be made above the opening of your ear or behind your ear and in your ear canal. The approach depends on the type of mastoidectomy planned and the extent of disease.
- 3.Mastoid drilling — Using a high-speed drill with microscopic visualisation, the surgeon carefully removes the mastoid cortex and opens the mastoid air cell system, identifying and clearing all diseased tissue.
- 4.Disease clearance — All infected tissue, cholesteatoma and diseased mucosa is meticulously removed. The facial nerve, ossicular chain and labyrinth are carefully identified and protected throughout.
- 5.Reconstruction — Where appropriate, the eardrum is repaired (tympanoplasty) and the ossicular chain is reconstructed to preserve or improve hearing. The surgical cavity is lined and the wound is closed.
The operation can take between one and three hours, depending on the extent of disease and whether reconstruction is performed simultaneously.
Why Choose Royal Eye & Ear Hospital for Mastoidectomy?
Not all cataract surgeries are equal. The skill of your surgeon, the quality of the lens, and the care you receive after surgery all determine your outcome.
- 🏥 We are a specialist eye and ear hospital — ear surgery is a core part of what we do. Mastoidectomy is not an occasional procedure at Royal Eye & Ear Hospital. It is a fundamental part of our ENT surgical expertise, performed within a dedicated ENT surgical environment with the tools, team and protocols that complex ear surgery demands.
- 👁️ Our ENT surgeon Dr. Mohamed Arab has extensive surgical experience performing mastoidectomy, tympanoplasty and middle ear surgery across two decades of ENT practice in Egypt, Somalia and Kenya.
- 📍 Conveniently Located in Nairobi Based on 3rd Parklands Avenue, we serve patients from Westlands, Parklands, Gigiri, Muthaiga, and across the greater Nairobi region.
- 💊 The facial nerve runs directly through the surgical field during mastoidectomy. Our surgical approach prioritises identification and protection of the facial nerve throughout the procedure, minimising the risk of facial nerve injury
- 🔬 All mastoidectomy procedures at Royal Eye & Ear Hospital are performed under operating microscope magnification, providing the high-magnification, high-illumination visualisation that precise mastoid drilling and cholesteatoma removal requires.
Benefits of Mastoidectomy
Clears Chronic Infections
Removes diseased tissue and air cells that antibiotics cannot reach, stopping ongoing irritation.
Prevents Dangerous Complications
Halts aggressive tissue growth to protect you from severe risks like meningitis, brain abscesses, or facial damage.
Preserves and Improves Hearing
Stops bone erosion to protect your remaining hearing, creating a healthy foundation for potential hearing reconstruction.
Stops Chronic Ear Discharge
Eliminates the infected cavity responsible for foul-smelling drainage, relieving a stressful everyday symptom.
Protects the Facial Nerve
Clears away deep growths before they can erode the nearby nerve pathways and cause facial paralysis.
Provides Cochlear Implant Access
Creates a safe, open pathway for surgeons to insert cochlear implant electrodes for patients with severe hearing loss
What to Expect After Mastoidectomy
Timeline:
Days 1–3: Immediate Post-OpYou will wake up with a head dressing. Expect soreness, swelling, temporary hearing loss from packing, and mild dizziness. Rest at home and take your prescribed medications.
Days 3–7: First WeekYour doctor removes the dressing at your first appointment. Keep the ear completely dry. Do not blow your nose, sneeze with your mouth open, and resume light desk work if feeling well.
Weeks 1–4: Gradual HealingPain and swelling decrease significantly. Most people return to work or school within two weeks. Keep protecting the ear from water. Hearing will slowly improve as internal packing dissolves.
Weeks 4–12: Full RecoveryAvoid strenuous exercise for the first month. The surgical site heals fully by week 12. Your specialist will perform a final hearing test between weeks 6 and 12.
Long-Term: Ongoing CareDepending on your surgery type, you may need lifetime water precautions and regular ENT clinic visits to clean the ear cavity or monitor for any returning tissue growth.
Recovery Do's and Dont's:
✅ Take all prescribed antibiotics, ear drops and pain relief exactly as directed
✅ Keep the ear completely dry at all times — use a cotton wool ball with Vaseline in the ear opening when showering.
✅ Attend every post-operative appointment without exception.
✅ Rest and avoid strenuous activity for at least four weeks.
✅ Sleep with your head elevated in the first week to reduce swelling.
✅ Report any sudden facial weakness, severe vertigo, worsening pain or fever immediately.
❌ Do not let any water enter the ear canal — no swimming or submerging the head.
❌ Do not blow your nose — sneeze with your mouth open if needed.
❌ Do not fly by aeroplane for at least two to four weeks after surgery unless cleared by your surgeon.
❌ Do not do strenuous exercise or heavy lifting for at least four weeks.
❌ Do not use cotton buds or insert anything into the ear canal.
❌ Do not miss follow-up appointments — ongoing ear care is essential after mastoidectomy.
RESULTS
What Results Can You Expect?
1
High Success Rate
Achieves complete clearance of infection or abnormal tissue growth in the vast majority of cases.
2
Life-Protecting Prevention
Stops advanced ear disease from causing severe complications like meningitis, brain abscesses, or facial paralysis.
3
Hearing Care and Reconstruction
Protects your remaining hearing while creating a healthy, properly healed environment for potential hearing improvement.
4
Relief from Chronic Drainage
Reliably stops the continuous, foul-smelling ear discharge that impacts your daily comfort and confidence.
Risks & Considerations of Mastoidectomy⚠️
Like all surgical procedures, Mastoidectomy carries a small risk of complications. At Royal Eye & Ear Hospital, our surgeons take every precaution to minimise these risks — and serious complications are rare.
1
Facial Nerve Injury
Because the nerve passes through the surgical area, injury can cause temporary weakness or, very rarely, permanent facial paralysis.
2
Infection and Poor Healing
There is a small risk of infection, which can be managed with prescribed antibiotics and keeping the ear dry.
3
Tinnitus and Dizziness
You may experience temporary ringing in the ear or vertigo, which usually clears up as the ear heals.
Patient outcome note:
Your surgeon will discuss all potential risks clearly before surgery. For patients with cholesteatoma or advancing mastoid infection, the risk of surgery is consistently and substantially outweighed by the risk of leaving these conditions untreated.
Frequently Asked Questions About Mastoidectomy
Cholesteatoma is an abnormal accumulation of skin cells that develops behind the eardrum, typically as a result of recurrent ear infections or a retracted eardrum. Despite being non-cancerous, cholesteatoma is locally destructive — it slowly erodes the surrounding bone, destroys the tiny hearing ossicles, and can extend to damage the facial nerve, the inner ear and the structures separating the ear from the brain. If left untreated, cholesteatoma can cause permanent hearing loss, facial paralysis, meningitis and brain abscess. Mastoidectomy is the only effective treatment for cholesteatoma.
The procedure is performed under general anaesthesia so you feel nothing during surgery. After surgery, the ear and surrounding area will be sore and swollen for several days — managed with prescribed pain relief. Mild dizziness and a change in taste are common in the first weeks and usually resolve with time. Significant pain is uncommon and typically indicates a complication that should be reported promptly.
You must keep your ear completely dry after surgery. Swimming or submerging your head is not allowed until your surgeon confirms full healing, usually after four to six weeks. If you have a canal wall down mastoidectomy, you will need to wear custom earplugs permanently whenever you swim, shower, or bathe. Your surgeon will provide specific guidelines based on your exact procedure.
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