Today, there are many drugs that can cure mastoiditis without surgery. For this, different groups of antibiotics are used. If conservative treatment is useless, mastoidectomy is prescribed.
Mastoidectomy: the essence of the procedure
The operation is used to remove purulent contents from the mastoid process. Three large groups of such surgical intervention are distinguished:
- Simple. Manipulation is performed through the ear canal or a small incision behind the ear. After opening the mastoid process, pus is removed. Then there is a slight damage to the tympanic membrane to ensure the outflow of pus.
- Radical. Includes complete removal of the tympanic membrane. Almost all structures of the middle ear are eliminated except stapes. This allows the surgical method to further carry out operational impact.
- Modified. During the treatment, the integrity of the tympanic membrane and structures is preserved. This has a positive effect on the recovery forecast.
Indications
The main purpose of the operation is to preserve the hearing and sanitize the ear. It is carried out in those patients who have a pathogenic stable microflora in the auditory canal. Inflammation can lead to ingrown skin of the auditory canal through the damaged area in the tympanic membrane.
This cyst is called cholesteatoma. If it is not removed in time, it will increase in size and adversely affect adjacent bone tissues.
In addition to a cystic tumor, the indication for surgery is severe chronic infections of the middle ear, the lack of the effect of usual medication, at the risk of developing cerebral abscess, and inflammation of the meninges.
Indications for operation: mastoiditis
How is
performed The procedure is performed under general anesthesia. The patient lies on his back with his head turned to the healthy side.
Preparation of
Before the operation, diagnostic activities are designed to accurately establish the diagnosis. X-ray examination is carried out, since in this picture the mastoid process is clearly visible. To prevent the development of complications, antibacterial drugs may be prescribed before the procedure.
Preparation includes:
- inspection and palpation of the occult area,
- otoscopy,
- microscopy,
- audiometry,
- computed tomography.
Description of the process
Carrying out the operation requires a surgeon of high accuracy and professionalism, since the actions themselves are quite complex. The operation takes an average of 1.5 hours.
The stages of the operation are as follows:
- The person is immersed in general anesthesia, the head is firmly fixed in the right direction.
- An arc-shaped cut is made at a distance of 1 cm from the sink. If the patient is a child under two years of age, the skin dissects immediately to the bone.
- After layer-by-layer cutting, the bone is visualized. With the help of a special tool, the doctor begins to hollow the bone until the appearance of the appendage cells. In children, the hammer is not used, mostly manipulations are carried out using sharp spoons.
- After opening the cells, the purulent masses are removed, drainage is introduced, which contributes to the outflow of pus.
- After the operation, antibiotics are used, tampon fixation and suturing takes place.
Mastoidectomy of the temporal bone in our video:
Post-operative care and recovery
Hospitalization lasts about 5-7 days. Return to work a person can in 1-3 weeks after discharge.
Sometimes it becomes necessary to perform a second operation aimed at hearing restoration. It is carried out in 6-12 months.
The need for it can arise if you need to re-examine cavities and identify the remaining areas of the inflammation focus.
The recovery period is quite easy. Immediately after the operation, there is swelling, it is possible to develop partial numbness of the face. In the first few months it is impossible:
- to lift weights,
- to swim in the pool and reservoirs,
- not to allow water to enter the ear canal,
- to blow your nose,
- to travel in trains and on airplanes.
Immediately after surgery, the dressing is replaced for the first time on the fifth day. If there is blood in the dressing or after a migraine, dizziness, this should be reported to the doctor immediately. With a slow healing of the wound, various ointments or physiotherapy are used.
Treatment after surgery
In order to get rid of the problem completely, additional treatment is prescribed.
Medication
Previously, the course of antibiotics was continued for 5-7 days. Anemia is mandatory, that is, the introduction of vasoconstrictor drugs into the pharyngeal mouth of the auditory tube. If necessary, the wound is treated with antiseptic solutions.
Change of dressings may include additional administration of antibacterial drugs.
Folk recipes
Folk methods are mainly aimed at strengthening immunity. You can not use compresses during the recovery period, but after removing the bandage, you can use propolis tinctures, chamomile to treat external wounds. Inside apply anti-inflammatory decoctions, for example, from chamomile. They allow to accelerate the healing process.
Physiotherapy
If the wound does not heal well, ultraviolet radiation is prescribed. All procedures are appointed by the doctor. For faster treatment, electrophoresis may be prescribed, but its use is only relevant for the healing of external wounds.
How to treat mastoiditis without surgery in our video:
What can not be done
You can not blow your nose, get into the situation of a sharp change in atmospheric pressure. Doctors strongly recommend avoiding open reservoirs and swimming pools. It is allowed to make various antiseptic dressings with drugs, which the doctor appointed.
Possible complications of
To negative consequences:
- appearance of permanent purulent discharge from the ear,
- infectious complications, including meningitis, cerebral abscess,
- hearing impairment.
Rarely, damage to the facial nerve can occur, which leads to paralysis of half of the face, temporary loss of taste sensations. In 3% of cases, hearing loss is noted.
Disturbing symptoms of
If you see a discharge from the ear or blood on the bandages, you should contact your doctor as soon as possible. Signs of the development of meningitis are: dizziness, combined with headache, impaired swallowing. Fever, shortness of breath, nausea and other signs of intoxication can talk about the development of inflammation.