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Otorhinolaryngology focuses on the ear, nose, and throat. Learn about the diagnosis and treatment of hearing loss, sinusitis, tonsillitis, and voice disorders.
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Recovering from a mastoidectomy is a process that requires patience. While the patient typically leaves the hospital within 24 hours, the internal healing of the bone and ear tissues takes several weeks to months. The recovery is generally not characterized by severe pain, but rather by a feeling of fullness, odd sounds in the ear, and fatigue.
Understanding what is normal during this time helps reduce anxiety. The ear is a sensitive organ, and it reacts to surgery with swelling and fluid production. Following the postoperative instructions is just as important as the surgery itself to ensure a dry, healthy result. This section guides patients through the timeline of healing, wound care, and the signs that indicate a need for medical attention.
When you wake up from surgery, you will likely have a large bandage wrapped around your head. This “glasscock dressing” applies gentle pressure to the ear to prevent a collection of blood (hematoma) under the skin. It might feel tight and uncomfortable, but it is usually removed the morning after surgery.
You may feel dizzy or off-balance. This is normal because the surgery involves the area right next to your balance organs. The dizziness usually settles down within a few days as the inflammation subsides. You might also notice a change in taste. The nerve responsible for taste on the side of the tongue runs through the middle ear and can be stretched during surgery, causing a metallic taste or numbness. This, too, is usually temporary.
Most patients are surprised to observe that mastoid surgery is not agonizingly painful. The bone itself has few pain nerves. The discomfort usually feels like a dull, throbbing ache around the ear or in the neck muscles.
Doctors typically prescribe mild narcotic pain medication for the first few days, but many patients switch to over-the-counter acetaminophen (Tylenol) quickly. It is generally advised to avoid aspirin or ibuprofen (NSAIDs) for the first week or two, as these can increase the risk of bleeding. Keeping the head elevated on two pillows while sleeping helps reduce the throbbing sensation.
If the surgery was performed with an incision behind the ear, there will be stitches or staples. The area should be kept clean and dry. You may be allowed to wash your hair after a few days, provided you protect the ear from water.
The most critical rule of recovery is to keep water out of the ear canal. Water carries bacteria that can infect the healing graft and bone. Patients are often told to coat a cotton ball in Vaseline and place it in the outer ear when showering. Do not scrub the incision; just let soapy water run over it gently. The stitches are usually removed at the first follow-up appointment, about one week after surgery.
The ear canal will be packed with a dissolvable sponge or antibiotic ointment. This packing holds the new eardrum in place. Because the ear is plugged, your hearing will be very muffled—worse than before surgery. This sensation can be frightening, but it is expected. You will not know the true result of your hearing until the packing dissolves and the swelling goes down, which takes about 6 to 8 weeks.
It is normal to have some bloody discharge from the ear for the first week. You might hear popping, crackling, or squishing sounds in your ear. This noise is the sound of air and fluid moving around in the healing middle ear space. It is a sign that the ear is trying to ventilate, which is a beneficial thing. Do not blow your nose forcefully, as the pressure can force air up the Eustachian tube and displace the delicate graft. If you need to sneeze, do it with your mouth open.
Rest is vital. For the first two weeks, you should avoid heavy lifting, straining, or intense exercise. Straining raises the blood pressure in the head and can cause bleeding. You should generally avoid flying for at least a month, as the pressure changes in the cabin can be painful and damaging to the healing ear.
Most adults take 1 to 2 weeks off work. Children can usually return to school after a week, provided they sit out of gym class and recess. Contact sports should be avoided for a longer period to protect the head from impact.
Mastoid surgery is not a “fix it and forget it” procedure. It requires lifelong monitoring, especially for cholesteatoma. The disease has a tendency to come back. Patients typically see their ENT specialist every 6 to 12 months for a check-up.
If a “mastoid bowl” was created, these visits are for cleaning. The doctor will use a microscope and a small vacuum to remove the wax and dead skin that accumulates in the cavity. This cleaning is painless and prevents infection. Regular hearing tests will also be done to monitor stability. With proper care and regular visits, patients can live a normal, active life free from the chronic infections that once plagued them.
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Most surgeons recommend waiting 4 to 6 weeks. The graft needs to be strong enough to withstand the pressure changes of takeoff and landing.
The chorda tympani nerve, which controls taste on the side of the tongue, runs through the ear. It is often stretched during surgery, causing a metallic or numb taste. The condition usually recovers over a few months.
Once the ear is fully healed (usually 2-3 months), swimming is often allowed. However, if you have a mastoid bowl, you may need to use an earplug to prevent dizziness from cold water entering the cavity.
The top of the ear might feel numb after surgery because small skin nerves are cut during the incision. This sensation can last for 6 months or longer, but sensation usually returns slowly.
If you have a fever over 101°F, increasing pain that medicine doesn’t help, or bright red, hot swelling behind the ear, call your doctor immediately. These are signs of a postoperative infection.
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