Ear Surgery in Gandhinagar & Ahmedabad | Niraaya Hospital

Mastoidectomy is the surgical removal of diseased air cells in the mastoid bone - the portion of the skull immediately behind the ear. This procedure is most commonly performed for two conditions: chronic mastoid infection not responding to medication, and cholesteatoma - an abnormal pocket of skin (keratinised squamous epithelium) that grows in the wrong place, within the middle ear and mastoid. Cholesteatoma is a serious, locally destructive condition that silently erodes bone as it expands.

Left untreated, cholesteatoma causes progressive erosion of the hearing bones (ossicles) leading to conductive hearing loss, erosion of the bony canal overlying the facial nerve causing facial nerve palsy, erosion into the inner ear causing sensorineural hearing loss and severe vertigo, breach of the bone separating the ear from the brain leading to meningitis or brain abscess, and rarely, life-threatening intracranial complications. Surgery is the only definitive treatment - there are no medications that stop cholesteatoma growth.

• Cortical (Simple) Mastoidectomy: Removes diseased mastoid air cells while preserving the posterior ear canal wall and the architecture of the middle ear. Often combined with tympanoplasty to repair the eardrum (combined approach tympanomastoidectomy). Preferred when cholesteatoma is limited to the mastoid.
• Modified Radical Mastoidectomy: Removes the posterior ear canal wall, creating a single open cavity between the mastoid and ear canal (mastoid cavity). Performed when cholesteatoma has caused significant canal wall erosion or when disease extent makes preservation impossible. Requires lifelong cavity care and annual follow-up.
• Radical Mastoidectomy: The most extensive form, removing the middle ear structures along with the mastoid. Reserved for extensive disease.

Hospital stay: 1-2 days. Canal packing or cavity dressing is managed over follow-up visits. Full recovery: 4-6 weeks. Because cholesteatoma can leave microscopic disease behind, a planned "second look" surgery at 12-18 months may be recommended to check for recurrence.

Stapedotomy is a highly specialised microsurgical procedure performed for otosclerosis - a condition in which abnormal bone remodelling within the middle ear causes the stapes (the smallest bone in the human body, only 3 mm in length) to become progressively fixed in place. Because the stapes must vibrate to transmit sound from the eardrum to the inner ear, its fixation causes progressive conductive hearing loss - typically beginning in young adulthood and worsening over years.

Otosclerosis is more common in women, may worsen during pregnancy, and often runs in families. Affected patients typically notice that they hear better in noisy environments than in quiet ones (a phenomenon called paracusis Willisii) - because background noise causes others to speak louder, compensating for their hearing loss. Audiometry and tympanometry confirm the diagnosis.

Under general or local anaesthesia and operating microscope magnification, the fixed stapes is surgically removed. A tiny titanium or Teflon prosthesis - a piston approximately 0.4-0.6 mm in diameter - is placed to restore the mechanical link between the incus (the middle ear bone above the stapes) and the inner ear. This allows sound energy to once again be transmitted to the cochlea.

Stapedotomy is one of the most technically precise microsurgical procedures in all of ENT - performed in a space barely 2-3 mm wide, adjacent to the facial nerve and the delicate membranous labyrinth of the inner ear. Dr. Patel's microsurgical training and experience make this procedure available to patients in Gandhinagar and Ahmedabad without the need to travel to larger cities.

Stapedotomy has a very high success rate - approximately 90-95% of patients experience significant, lasting hearing improvement. Many patients notice immediate improvement in hearing as they recover from anaesthesia. The procedure is reversible if needed, and the prosthesis functions for life in the vast majority of cases.

The facial nerve is responsible for all voluntary movement of the muscles of the face - blinking, smiling, raising the eyebrows, closing the mouth. It travels from the brain through a long, narrow bony canal (the Fallopian canal) within the temporal bone - the bone housing the ear - before emerging to innervate the facial muscles. Because this canal is rigid and unyielding, any swelling or compression within it can impair nerve function even without direct nerve injury.

Ear-related causes of facial nerve palsy requiring surgical decompression include:

• Cholesteatoma erosion of the Fallopian canal exposing and compressing the facial nerve
• Acute severe otitis media with facial nerve involvement
• Temporal bone fractures causing bony fragments to compress the nerve
• Herpes zoster oticus (Ramsay Hunt syndrome) - reactivation of varicella-zoster virus in the geniculate ganglion of the facial nerve, causing intense ear pain, blistering in and around the ear, hearing loss, and complete or partial facial paralysis
• Benign or malignant temporal bone tumours

Facial nerve decompression involves surgical opening of the bony Fallopian canal along the compressed segment, directly relieving the pressure on the nerve. The approach depends on the site of compression - transmastoid (through the mastoid bone, via a postauricular incision) for the vertical and tympanic segments, or middle cranial fossa (through a temporal craniotomy) for the labyrinthine segment. Often performed urgently, this procedure can reverse a complete facial nerve palsy if undertaken before permanent nerve degeneration occurs.

Complete facial nerve paralysis from a middle ear cause, particularly if rapidly progressive or not improving within 2-3 weeks of appropriate medical treatment (high-dose steroids, antiviral therapy for herpes zoster), is an indication for surgical exploration and decompression. The timing is critical - surgery performed within 2-3 weeks of onset achieves far better outcomes than late intervention. If you notice sudden facial drooping alongside ear symptoms anywhere in Gandhinagar, Ahmedabad, or surrounding Gujarat, seek specialist review at Niraaya Hospital immediately.

Ear lobe repair is a minor surgical procedure to correct a split, torn, or elongated ear lobe. The most common causes are heavy or large earrings that gradually stretch and ultimately tear through the lobe, accidental forceful tearing (earring caught on clothing or during a fall), and gauge (flesh tunnel) ear piercings that are subsequently removed, leaving a large hole in the lobe.

Split or torn ear lobes cause cosmetic concern and make it impossible to wear conventional earrings. Repair restores the natural appearance of the lobe and allows re-piercing after the wound has healed.

Ear lobe repair is performed under local anaesthesia as a day procedure - no hospital admission is required. The torn or split edges are carefully freshened (a small margin of skin is removed to create fresh, vascular wound edges that will heal together reliably). The lobe is then closed in two layers - the deeper layer with absorbable sutures and the skin with fine non-absorbable sutures, removed at 7-10 days. The result is a natural-appearing, well-healed ear lobe.

Re-piercing can be safely performed 3 months after surgery, ensuring the new piercing is placed through fully healed, strong scar tissue.

A keloid is an overgrowth of scar tissue that extends beyond the boundaries of the original wound, caused by an exaggerated healing response in genetically predisposed individuals. Ear keloids most commonly develop at the site of ear piercing - particularly in darker-skinned individuals - and can grow to considerable sizes over months to years, causing a firm, raised, often itchy or painful lump on the ear lobe or cartilage.

Ear keloids are a cosmetic concern, can cause discomfort, and make wearing earrings impossible. Unlike hypertrophic scars (which stay within the original wound margins and often improve with time), keloids do not resolve spontaneously and tend to enlarge progressively without treatment.

Keloid management requires a multi-modal approach - surgical excision alone has a high recurrence rate (up to 50-80%), as the surgical wound itself can trigger a new, often larger keloid.

At Niraaya Hospital, Gandhinagar, the management protocol includes:

• Surgical excision - complete removal of the keloid under local anaesthesia, with careful technique to minimise wound tension
• Intralesional steroid injection - triamcinolone acetonide injected into the wound bed immediately after excision, and repeated at 4-6 week intervals post-operatively
• Silicone gel sheeting - applied to the wound site during healing to apply mechanical pressure and reduce keloid reformation
• Pressure therapy - clip-on pressure earrings worn on the lobe for 12-18 months to maintain continuous gentle pressure on the scar
• Radiation therapy - low-dose adjuvant radiation delivered within 24-48 hours of surgery in selected refractory cases, highly effective at preventing recurrence

Dr. Patel counsels every keloid patient thoroughly about recurrence risks, expected outcomes, and the commitment required for multi-modal post-operative management before proceeding with surgery.