This surgery used to be a common way to treat an infection in mastoid air cells. In most cases, the condition was caused by an ear infection that spread to the bone in the skull. This surgery is not often performed now.

You will receive general anesthesia, so you will be asleep and pain free. The surgeon will make a cut behind the ear. A bone drill will be used to gain access to the middle ear cavity that is behind the mastoid bone in the skull. The infected parts of the mastoid bone or ear tissue will be removed and the cut is stitched and covered with a bandage. The surgeon may put a drain behind the ear to prevent fluid from collecting around the incision. The operation will take 2 to 3 hours.

Mastoidectomy may be used to treat:

• Cholesteatoma
• Complications of an ear infection (otitis media)
• Infections of the mastoid bone that do not get better with antibiotics
• To place a cochlear implant

Risks may include:

• Changes in taste
• Dizziness
• Hearing loss
• Infection that persists or keeps returning
• Noises in the ear (tinnitus)
• Weakness of the face
• Cerebrospinal fluid leak

Tell your surgeon or nurse if:

• You are or could be pregnant
• You are taking any medicines, including medicines, supplements, or herbs you bought without a prescription
• You have been drinking a lot of alcohol, more than 1 or 2 drinks a day

Planning for your surgery:

• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your health care provider who treats you for these conditions.
• If you smoke, it’s important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
• If needed, prepare your home to make it easier to recover after surgery.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

• You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
• Ask your surgeon which medicines you should still take on the day of surgery.
• Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes breakout, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon told you to take with a small sip of water.
• Follow instructions on when to arrive at the hospital. Be sure to arrive on time.

You will have stitches behind your ear and there may be a small rubber drain. You may also have a large dressing over the operated ear. The dressing is removed the day after surgery. You may need to stay in the hospital overnight. Your provider will give you pain medicines and antibiotics to prevent infection.

Mastoidectomy successfully gets rid of the infection in the mastoid bone in most people.

Simple mastoidectomy; Canal-wall-up mastoidectomy; Canal-wall-down mastoidectomy; Radical mastoidectomy; Modified radical mastoidectomy; Mastoid obliteration; Retrograde mastoidectomy; Mastoiditis - mastoidectomy; Cholesteatoma - mastoidectomy; Otitis media - mastoidectomy

Chole RA, Sharon JD. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 140.

Kesser BW. Surgery of ventilation and mucosal disease. In: Brackmann DE, Shelton C, Arriaga MA, eds. Otologic Surgery. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 5.

MacDonald CB, Wood JW. Mastoid surgery. In: Myers EN, Snyderman CH, eds. Operative Otolaryngology - Head and Neck Surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2018:chap 134.

Stevens SM, Lambert PR. Mastoidectomy: surgical techniques. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 143.

Updated by: Ashutosh Kacker, MD, FACS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.