The mastoid bone is the hard bone that you feel if you press behind your ear. Within this bone there is an air filled space called the mastoid cavity. This air filled space connects with the middle ear which is also air filled. Infections of the middle ear can spread into the mastoid cavity causing more serious infection called mastoiditis. A CT scan may be necessary to evaluate this possibility further.
Many patients prefer to be completely asleep.
In small perforations, the operation can be easily performed under local anesthesia with intravenous sedation. An incision is made into the ear canal and the remaining eardrum is elevated away from the bony ear canal and lifted forward. The operating microscope helps to enlarge the view of the ear structures, giving a more detailed image to the ear surgeon. If the perforation is very large or the hole is far forward and away from the view of the surgeon, it may be necessary to perform an incision behind the ear. This elevates the entire outer ear forward, gaining access to the perforation.