1. Mastoidectomy
By: Shay Praag

2. What is it?
Removal of part of the mastoid bone when medical assistance is needed.
A Mastoidectomy is only done if antibiotics have been tried and aren’t working.
Done when there is a cholesteatoma, skin cyst in middle ear.

3. Simple Mastiodectomy
Only infected air cells are removed

4. Radical Mastoidectomy
Remove almost all of the bone.
Tympanic Membrane and middle ear bones are removed.
Stapes if spared if possible.

5. Exposing the Mastoid Bone

6. Anesthesia, Position, Prep, Drape
Local, Supine with donut under head, Shave if Surgeon prefers, restrain hair with tape, hairline to shoulder to middle of face, drape with 3-4 sterile towels, cover head with disposable drape, place 2 towels at neck.

7. Instruments and Supplies
Ear Instrument set
Cutting burs
Suction Irrigator
Instruments to take small skin graft
Prep set
Basin set
Head and Neck pack
Microscope drape
Gel Foam
Suture (SP)
Dressing (SP)

8. Procedure Steps:
1. Inject ear with local. Get skin graft prior to ear prep and draping.
2. Make incision behind ear.
3. Harvest temporalis fascia.
4. Drill mastoid bone. Use suction irrigator to suction plume and bone fragments and to prevent charring of bone.
5. Surgeon removes ossicles at this point.
6. Use Rosen needle to remove cholesteatoma.
7. Surgeon places fascia graft
8. Cut Gelfoam into squares to pack mastoid.
9. Close with absorbable suture.
10. Skin closed with 4-0
11. Pack external canal.
12.Fluffed gauze placed around ear.