Mastoid Bowl Cleaning

What Is a Mastoid Bowl?

A mastoid bowl is a cavity inside the ear. It is a deep pocket adjacent to and behind the eardrum. It is lined with skin and it secretes oils and produces dead skin that forms a buildup that needs to be cleaned periodically. It can retain water so it increases the risk of ear infection with water exposure.

What Causes a Mastoid Bowl?

A mastoid bowl is most commonly the result of surgery for cholesteatoma. A cholesteatoma is a skin cyst that originates from the ear drum. As the cyst grows it damages the hearing bones and ear drum causing hearing loss. Further growth puts the inner ear at risk. Deafness and vertigo may occur. Very advanced cholesteatomas may risk facial nerve damage, spinal fluid leak, or meningitis. Treatment is needed to remove cholesteatomas before these occur. When the cholesteatoma is small, it can be completely removed. When it is more advanced complete removal is not possible. In these cases, it is reduced but the lining is left deep inside the ear. A mastoid bowl is created by the surgeon so that the lining is visible through the ear. The surgeon may then stabilize the ear and keep watch over the cholesteatoma in the office by cleaning the mastoid bowl periodically.

Who Needs Cleaning?

Anyone who has had a cholesteatoma may need follow up. If a mastoid bowl was created to treat the cholesteatoma, most likely cleaning will be needed. The frequency depends on the amount of secretions created by the cavity. This can vary between patients. Cleaning may be needed annually or biannually.

How Is the Bowl Cleaned?

In your doctor’s office, you will lay down in the exam chair. Cleaning is done with the aid of the microscope. Small suctions and ear instruments are used to remove debris.

Does It Hurt?

Mastoid cleaning is rarely painful. Discomfort is usually associated with an overdue cleaning. Cleaning can cause vertigo. Mastoid bowls are prone to something called the caloric effect. This means that temperature changes in the ear are sensed by the inner ear balance system resulting in stimulation. The suction used to clean the bowl cools the temperature in the ear slightly. The vertigo resolves quickly after the temperature returns to normal.

How Can I Care for My Ear in Between Cleanings?

Keeping the mastoid bowl dry is the most important care. Because the bowl can retain water more than an ear with normal anatomy, water exposure leaves the bowl damp for long periods. This creates an environment that encourages infection. Infection increases secretions and will often cause drainage from the ear. The ear can be protected from moisture by plugging it with a cotton ball coated in Vaseline prior to water exposure. Keeping the head above water is best. Do not allow water directly into the ear in the shower. If water is allowed in, drying the ear with a hair dryer can help. Hold it at arm’s length away from the wet ear. Do not use heat. Apply the dryer until the ear is dry.

Sometimes, despite strict water avoidance, mastoid bowls still drain. If this happens, you should see your doctor sooner than scheduled. Medicated drops or powders may stabilize the ear. Rarely, surgery is required to stabilize the ear.