to phil Re: Sherry - Mastoid Removal, Canal Wall Down?

[Guest guest]

phil,

thank you for the explanation of the different types procedures. you have a way of writing that make even the lay person understand. i was very confused to the difference in procedures. by your explanation i now can tell the type of surgery my daughter had last year was a radical mastoidectomy and they also removed part of the canal wall. once again thank you for the explanation.

carmenPhil <psmorris@...> wrote:

Hi SherryI'm not quite clear what you mean by mastoid removal. It sounds as if you might be referring to a canal wall down or an open cavity mastoidectomy which would remove the inside of the mastoid bone and the part of it which forms the back wall of the ear canal - you've probably had several mastoidectomies already but perhaps they were all canal wall up. I found these notes among my files which might help to explain the mastoid bone and canal wall down a little better.Mastoidectomy is performed to remove infected air cells within the mastoid bone caused by mastoiditis , ear infection, or an inflammatory disease of the middle ear (cholesteatoma). The cells are open spaces containing air that are located throughout the mastoid bone. They are connected to a cavity in the upper part of the bone, which is in turn connected to the middle ear. As a result, infections in the middle ear can sometimes spread through

the mastoid bone. When antibiotics can't clear this infection, it may be necessary to remove the infected air cells by surgery.

The ear canal is partly bone and partly cartilage. The bony portion is the part that is farthest inside, closest to the eardrum. The posterior bony canal wall (the canal wall closest to the back of the head) is part of the mastoid bone. The mastoid bone is the large, rounded bone you can feel by touching just behind your ear lobe. Within the mastoid bone, there is a honeycomb of "air cells." In other words, the mastoid is not a solid bone, but rather it contains numerous tiny air pockets. These air pockets are connected to a BIG air pocket behind the eardrum. This big air pocket is known as the "middle ear space."

The most common reason to perform a mastoidectomy is an exceptionally aggressive middle-ear infection, one that has begun to destroy the delicate bony walls of the mastoid air cells. In a radical mastoidectomy, part of the mastoid bone is removed.

It was very common to remove the canal wall as part of this procedure. (Nowadays, many ENTs try to leave the canal wall intact, but in cases of extensive infection, we still may find it necessary to "take the canal wall down.") The outer (cartilage) part of the canal was usually left relatively intact. This operation leaves the patient with an open flask-shaped cavity. The outer part of the canal was still roughly cylindrical, but as you look towards the eardrum (or what used to be the eardrum) the space becomes becomes very wide -- you would be looking into a space created by the absence of the posterior canal wall and mastoid bone.

This cavity is typically skin-lined, and it tends to accumulate wax and skin debris and needs to be cleaned out regularly. If the wax and debris are not removed, they can become a great breeding ground for bacteria and fungi. This in turn can lead to foul-smelling ear drainage, ear pain, itching and even ringing (tinnitus) or dizziness.

Phil

[Guest guest]

I have had 11 left ear surgeries starting at the age of 7 and 8 of them in

the last 15 years. They have tried reconstruction of all 3 bones twice now

with no luck. I have had an ear infection now since Feb. some time draining

sometimes not always still infected tried different antibiotics and eardrop.

I know they have removed the curve in my ear it is a straight shot all the

way in the mastoid still seems to be intact. I have new insurance and a new

Dr. He is suggesting removing the whole mastoid bone. I think I understand

the procedure but if this would stop ear infections why haven’t they done it

before. And what if any are the pit falls of this surgery and what is the

recovery period. Thanks in advance for all your help.

Sherry

>From: CARMEN PONCE <just_me92844@...>

>Reply-cholesteatoma

>cholesteatoma

>Subject: to phil Re: Sherry - Mastoid Removal, Canal Wall

>Down?

>Date: Tue, 23 Sep 2003 14:35:42 -0700 (PDT)

>

>phil,

>thank you for the explanation of the different types procedures. you have

>a way of writing that make even the lay person understand. i was very

>confused to the difference in procedures. by your explanation i now can

>tell the type of surgery my daughter had last year was a radical

>mastoidectomy and they also removed part of the canal wall. once again

>thank you for the explanation.

>

>carmen

>

>Phil <psmorris@...> wrote:

>Hi Sherry

>

>I'm not quite clear what you mean by mastoid removal. It sounds as if you

>might be referring to a canal wall down or an open cavity mastoidectomy

>which would remove the inside of the mastoid bone and the part of it which

>forms the back wall of the ear canal - you've probably had several

>mastoidectomies already but perhaps they were all canal wall up. I found

>these notes among my files which might help to explain the mastoid bone

>and canal wall down a little better.

>

>Mastoidectomy is performed to remove infected air cells within the mastoid

>bone caused by mastoiditis , ear infection, or an inflammatory disease of

>the middle ear (cholesteatoma). The cells are open spaces containing air

>that are located throughout the mastoid bone. They are connected to a

>cavity in the upper part of the bone, which is in turn connected to the

>middle ear. As a result, infections in the middle ear can sometimes spread

>through the mastoid bone. When antibiotics can't clear this infection, it

>may be necessary to remove the infected air cells by surgery.

>

>The ear canal is partly bone and partly cartilage. The bony portion is the

>part that is farthest inside, closest to the eardrum. The posterior bony

>canal wall (the canal wall closest to the back of the head) is part of the

>mastoid bone. The mastoid bone is the large, rounded bone you can feel by

>touching just behind your ear lobe. Within the mastoid bone, there is a

>honeycomb of " air cells. " In other words, the mastoid is not a solid bone,

>but rather it contains numerous tiny air pockets. These air pockets are

>connected to a BIG air pocket behind the eardrum. This big air pocket is

>known as the " middle ear space. "

>

>The most common reason to perform a mastoidectomy is an exceptionally

>aggressive middle-ear infection, one that has begun to destroy the delicate

>bony walls of the mastoid air cells. In a radical mastoidectomy, part of

>the mastoid bone is removed.

>

>It was very common to remove the canal wall as part of this procedure.

>(Nowadays, many ENTs try to leave the canal wall intact, but in cases of

>extensive infection, we still may find it necessary to " take the canal wall

>down. " ) The outer (cartilage) part of the canal was usually left relatively

>intact. This operation leaves the patient with an open flask-shaped cavity.

>The outer part of the canal was still roughly cylindrical, but as you look

>towards the eardrum (or what used to be the eardrum) the space becomes

>becomes very wide -- you would be looking into a space created by the

>absence of the posterior canal wall and mastoid bone.

>

>This cavity is typically skin-lined, and it tends to accumulate wax and

>skin debris and needs to be cleaned out regularly. If the wax and debris

>are not removed, they can become a great breeding ground for bacteria and

>fungi. This in turn can lead to foul-smelling ear drainage, ear pain,

>itching and even ringing (tinnitus) or dizziness.

>

>Phil

>

>

>

>

>

>

>

>

>