Cholesteatoma Surgery: What to Expect Before, During & After
Cholesteatoma Surgery
Mastoidectomy and tympanoplasty are other names for cholesteatoma surgery, which is a surgical procedure used to remove a cholesteatoma—a benign skin growth in the middle ear—and repair any damaged areas of the ear. The usual course of action involves mending the eardrum and hearing mechanism, as well as removing any damaged tissue from the mastoid bone. The degree of the illness and the surgeon’s preference dictate the precise surgical technique, which may involve canal wall-up or canal wall-down procedures.
The operation is described in greater detail below:
Objective of Surgery:
The main aim of cholesteatoma surgery is to remove the cholesteatoma and repair the destroyed structures of the middle ear.
Anesthesia:
Usually, the procedure is carried out under general anesthesia, and the patient can be released in 24 hours.
Approach and Incision:
To get to the cholesteatoma and surrounding tissues, an incision is made behind the ear, occasionally extending into the ear canal.
Mastoidectomy:
To get to and remove the cholesteatoma, the surgeon will remove bone from its surrounding area.
Tympanoplasty
A cartilage or fascia graft will be used to repair a broken eardrum. Natural bone or cartilage or synthetic prostheses can be used to replace damaged small bones involved in hearing.
Canal Wall-Up or Canal Wall-Down:
Canal Wall-Up: The purpose of this method is to maintain the ear canal’s original form.
Canal Wall-Down: The procedure involves removing the bone that separates the ear canal from the mastoid, resulting in a bigger space.
Care following surgery:
Patients often have to take pain relievers, use topical ear drops, and avoid getting their ears wet after surgery. Additionally, they will have frequent follow-up visits to check on their hearing and recovery.
Recovery:
Although the recuperation period varies, patients usually require to stay out of the water and may have some discomfort or dizziness.
Dangers:
There are potential risks associated with surgery, such as facial nerve injury, dizziness, infection, and additional hearing loss.
Key Considerations:
Method of surgery:
The decision between canal wall-up and canal wall-down procedures is based on the specific circumstance, the severity of the illness, and the surgeon’s choice.
Results of hearing:
Following surgery, hearing outcomes might differ, and certain individuals may have hearing loss or alterations.
Recurrence:
A cholesteatoma can sometimes recur following surgery, necessitating additional therapy.
Follow-up:
Regular follow-up visits are essential for keeping an eye on recovery, evaluating hearing, and identifying any indications of relapse.
If any patient has any ENT -Ear nose throat problems and requires any , consultation ,online consultation ,or surgery in clinic of ENT specialist Doctor Dr Sagar Rajkuwar ,he may TAKE APPOINTMENT BY CLICKING ON THE LINK GIVEN BELOW-
Clinic address of ENT SPECIALIST doctor Dr Sagar Rajkuwar-
Prabha ENT clinic, plot no 345,Saigram colony, opposite Indoline furniture Ambad link road ,Ambad ,1 km from Pathardi phata Nashik ,422010 ,Maharashtra, India-Dr Sagar Rajkuwar (MS-ENT), Cel no- 7387590194 , 9892596635
What is a cholesteatoma?
Cholesteatoma is a collection of dead skin cells in the middle ear. This occurs when the ear
drum has been sucked into the middle ear and skin cells from the outer ear accumulate in the
pocket created. This pocket of cells slowly grows bigger over time causing destruction to
surrounding structures such as the bones of hearing. The sack can also grow backward into the
honey comb like bone called the mastoid bone.
A cholesteatoma will produce an offensive smelling discharge that doesn’t get better with
treatment, such as antibiotics or drops and often causes a hearing loss.
The mastoid bone: The mastoid bone is a prominent bone that can be felt behind the ear.
Under the hard outer surface there are many air filled spaces like honey comb. The mastoid
bone connects with the middle ear that is underneath the ear drum. The exact function of the
mastoid bone is unknown but the air filled spaces help to prevent pressure changes in the ear.
Why is surgery necessary for a cholesteatoma?
Patients experience hearing loss and repeated infections as their most frequent symptoms.
The biggest worry with a cholesteatoma, though, is the slight chance of life-threatening complications.
complications such as:
• Total hearing loss
• Injury to the equilibrium system
• Injury to the facial nerve, which regulates the muscles of the face
• Infection of the brain, such as meningitis, or an abscess
The objective of the procedure is to cleanse the ear and get rid of the cholesteatoma (skin sac).
keeping you safe and dry, reducing the possibility of these major issues. Additionally, it can happen on occasion.
The hearing may be enhanced.
What is the procedure for treating cholesteatoma surgically?
In the majority of instances, the procedure is carried out as a day case under general anaesthetic. A
Your surgeon will discuss with you the fact that only a small number of patients spend the night. The procedure
may require many hours to finish.
The procedure can be carried out in a variety of methods, depending on the size, degree, and
the cholesteatoma’s spread. They are:
• Tympanoplasty
• Removal of the mastoid
• Integrated strategy for tympanoplasty
The ear drum is reached using any of the techniques through an incision above or behind the ear, or if the
Although a cholesteatoma is little, it can occasionally be reached via the ear canal. Maybe not.
It’s impossible to predict which technique will be necessary until the day of your procedure, but your surgeon will be able to tell you which one it will be.
talk about the possible approaches that may be necessary prior to the procedure.
The cholesteatoma sac and its contents are elevated throughout the surgery.
taken out with caution. After that, a graft is used to reconstruct the eardrum. This graft is obtained from
different regions based on the needs for ear drum restoration. Cartilage is a possibility.
from the conchal bowl (the bowl-shaped portion of the tragus) or from the tragus (the protrusion in front of the ear)
the temporalis fascia (a tissue layer over the muscle over your ear) or your outer ear.
The bones of hearing can occasionally be rebuilt if they have been worn away by
the cholesteatoma, but a second operation could be necessary for this.
When the cholesteatoma has extended into the mastoid bone, which is characterized by a “honeycomb”-like bony projection
The surgeon will then extract some of the osseous air cells behind the ear in order to eliminate all the
cholesteatoma. This results in a flaw known as a mastoid cavity.
What should I anticipate following the procedure?
After the procedure, you will wake up wearing a head bandage that may be taken off the next day.
the next morning. if the surgery has been performed with no outside wounds all the way down the ear
a head wrap will be applied to the skin.
After filling your ear with cream or dressing, the surgeon will insert some cotton wool into it.
a peaceful bowl. The dressing inside the ear canal must be changed, but the cotton wool needs to be replaced.
You will have to remain there until your outpatient visit, which will occur 2 to 4 weeks after your
operation. Depending on the dressing you use, you may be prescribed ear drops to use until your
subsequent appointment. Before being, you will receive instruction from the ward staff.
released.
This packing occasionally occurs spontaneously, which is not an issue and does not need to be rectified.
replaced. From the vagina, a little amount of discharge is normal, and it may be bloody.
ear as a result of the mixture of packing, drops, and/or cream.
The stitches used in the procedure are absorbable and do not need to be taken out.
However, it takes them many weeks to go away.
When will I be able to return to work?
The majority of patients need a week or two away from their job. The severity of the will, however, will determine this.
The procedures needed as well as the nature of your employment. You’ll be able to talk about this with your
prior to the procedure, the surgeon.
DISCLAIMER-Some patients go to net and directly take treatment from there which can lead to catastrophic consequences-Then- Many people ask then why to read all this text -the reason is that it helps you to understand the pathology better ,you can cooperate with treatment better ,your treating physician is already busy with his patients and he does not have sufficient time to explain you all the things right from ABCD ,so it is always better to have some knowledge of the disease /disorder you are suffering from.
What are the dangers?
Before agreeing, you should be aware of the hazards associated with any surgery.
for the operation. The chance of contracting an infection is minimal. Using the antibiotic ear and maintaining the ear dry
This risk will be lessened by drops. This procedure may be unpleasant, but the discomfort may be managed.
with the hospital providing pain relievers.
Infection: Following surgery, there is a low chance of infection. Having blood is commonplace
You will be given antibiotic ear drops to use until your ear infection clears up if you have a discolored discharge from your ear.
follow-up. In some cases, antibiotic packaging is used in place of drops. It’s crucial
that you maintain a dry ear after the procedure. When taking a shower, refrain from swimming.
To prevent too much water from dripping, use cotton wool and Vaseline® in the outer ear.
in.
* skin numbness and scars: If an incision is necessary, you may have a scar behind the ear.
It usually heals into a thin line that is concealed behind the ear. A little bit sometimes
Your hair is shaved to keep the wound clean, and this will regenerate.
Some hazards are exclusive to ear surgery:
• Hearing loss: The healing process may result in a transient hearing loss.
dressing and packing. If the bones have been eroded by the cholesteatoma, this may be irreversible.
of hearing. If the ear is harmed, there is a slight risk of total hearing loss.
inner ear. Less than one percent of patients are impacted by this.
Vertigo is a sensation of dizziness. The balance system includes the ear. Patients often
After a cholesteatoma, you may feel dizzy, but this is only a transient effect that will usually go away by itself.
after a couple of hours. It will only occasionally last longer and may require some medication to aid with it.
the nausea and vomiting.
ringing in the ear is known as tinnitus. Following surgery, you could hear noises in your ear.
particularly if the hearing has deteriorated. This is transient and resolves with time.
Change in flavor: One of the nerves that carries taste from your tongue goes via your
ear. Your taste may change little, and it is frequently only transient.
• Facial paralysis: The nerve that governs the muscles that move your face travels.
through the middle ear. On very rare occasions, the facial nerve can be injured, which can result in:
lead to a momentary or persistent weakness on one side of the face.
Certain complications can be life-threatening.
- Common issues with all operations
- bleeding
- wound infection at the surgical site
- an allergic response to the tools, supplies, or prescription
- thromboembolism in the veins (VTE)
- infections of the chest
- Issues unique to this operation
- loss of hearing
- numbness in the ear
- harm to the face nerve
- a shift in preference
- dizzy
- ringing in the ear (tinnitus)
- discharge from the ear
- allergic response
- leaving behind some cholesteatoma
- The outcomes of this surgery
- discomfort
- your skin’s scars
Is it okay to get my ear wet?
It is crucial to maintain your ear dry following the treatment to aid in the healing process. Refrain from
bathing and submerging your head in water. We recommend that you take a shower if you have time.
applying Vaseline to cotton wool and placing it in the ear to prevent too much water from entering. You will
Until the ear has totally healed, which may take many weeks, this has to be done.
Do I need any more procedures or therapy?
After surgery, you will be watched for any signs of cholesteatoma returning. In a few
With a minor cholesteatoma, monitoring can be performed by checking your ear in the office. In
In other instances, your surgeon can schedule you for MRI scans every so often or for you to undergo additional procedures.
could need additional surgery for a second opinion. Your surgeon will be able to tell you what to expect.
Once the extent of the cholesteatoma has been determined, it is necessary to do this after your surgery.
In addition to surgery for cholesteatoma, some patients also need prolonged follow-up for cleansing.
their ear.
Are there any other options besides surgery?
The ailment cannot be treated with any medical methods. Regular cleaning is the only option.
to help lessen the infection and chance of problems, but this does not heal the ear.
illness. This might be more fitting for people who are at higher risk for a common
anesthetic. This will be thoroughly discussed with you if you don’t wish to contemplate surgery.
What follows the treatment?
The following day, you ought to be able to return home.
After around three weeks, you should be able to go back to your job.
If your surgeon had to mold your mastoid bone into a hole, you will likely have to return to the clinic many times during the first several months until the hole has fully healed.
To keep water out of your ear, use cotton wool and Vaseline. Don’t go swimming until your surgeon says your ear has healed.
Consistent exercise might speed up your return to your regular routine. Ask the healthcare team or your primary care physician for guidance before beginning any physical activity.
The majority of individuals recover well. But some cholesteatoma may remain if the bone of your ear canal was not extracted.
Overview
A cholesteatoma may harm your ear and lead to significant consequences. Only surgery can heal you.
