Tuesday, July 9, 2013

What's happening on Friday: Modified radical mastoidectomy

On Friday, I face what I very much hope to be my last ear surgery. Many people have asked me what I'm having done and I have struggled to explain it, so I did a bit of research to understand it myself. If you haven't read the history of where I've got to this place, go to the bottom of the post.

What is the name of the surgery?
It's called a modified radical mastoidectomy with tympanoplasty.
I'll spare you the gross-looking photos of
 cholesteatoma and mastoidectomies
 you can find on the Internet!!

What does that mean?
Mastoid air cells are open, air-containing spaces in the mastoid bone, the prominent bone located behind the ear that projects from the temporal bone of the skull. A mastoidectomy is the surgical removal of infected mastoid air cells. In a modified radical mastoidectomy, some middle ear bones are left in place and the ear drum is rebuilt with a typanoplasty.

My surgeon was hoping that he wouldn't have to do a mastoidectomy, but my ear bones have been so radically destroyed by this aggressive cholesteatoma that it's the only recourse left. I'm complicated.

What are the goals of the surgery?
The primary goal of the 3- to 4-hour surgery is to remove all of the cholesteatoma so I will have a clean, healthy ear without infection. The other goals are to have this be my last ear surgery, and ideally, restore some of the hearing in my ear. Given my complications so far, I don't get the impression that my surgeon is particularly hopeful about this outcome (restoring my hearing). My friend's daughter had to have a radical mastoidectomy (not a modified one), and she lost all the hearing in that ear. And obviously, I don't want this damn cholesteatoma eating into my brain any more!

What are the risks?
Complications are unusual, but they could include persistent ear discharge, infections (including meningitis or brain abscesses), hearing loss, facial nerve injury, temporary dizziness, or temporary loss of taste on the side of the tongue, in addition the usual risks of general anesthesia.

What will your recovery be like?
The surgery is outpatient, like the one I had last summer, so it will be much easier than the brain surgery and stay in ICU last December. I will go home after I wake up and lie in bed for several days, watching movies & TV shows, most likely. I found that I didn't have a lot of patience to read when I'm recovering (unlike me!), but I did stock up on some easier-to-read young adult titles.

The Internet sites say that recovery takes 4 weeks. These same sites also say that patients need to take pain medication for a few days, which is complete bullsh*t. I was on hardcore narcotics last August for a couple of weeks and really didn't feel back to myself for 3 or 4 weeks. I still have some pain from my last ear/brain surgery in December when I lie on my left side. I'll be going back to sleeping on my right side, will have to refrain from forceful nose blowing, won't be able to lift anything or do anything strenuous for a few weeks, and won't be able to get any water in my ear.

The hardest thing about having ear surgeries is that I become extremely sensitive to loud noise. This has me worried at the moment, because it seems that my younger boys are louder than ever at the moment. Mike has them signed up for various camps, but his #1 goal will be to keep them quiet when they are around.

Here's the history, if you haven't been following along:

My history with surgeries
First surgery last August
Speed bump: learning I have to have brain surgery
Extreme difficulties in getting brain surgery scheduled
Feeling a bit anxious about brain surgery
No more leaky brain!
Complicated case

Thanks for your good wishes and prayers--I'll take them all!

1 comment:

  1. “The hardest thing about having ear surgeries is that I become extremely sensitive to loud noise.”—This could mean that the surgery performed was successful. If it was the other way and your sense of hearing became dull, you should be alarmed. And as for the recovery, it doesn't happen instantly. You got to take all your medications and follow your doctor's advice.

    Hugh @USHealthWorks.com