Hello doctor, I am about to undergo a mastoidectomy next month, due to long term cholesteatoma (over five years). The surgery will entail removing a large amount of the mastoid bone. Of course, with this surgery comes the risk of damage through an incision of the facial nerve. This worries me a lot more than the pain of the operation and hearing loss (even though as of late I am pretty much deaf in my right ear and have been for quite a while now). But If I were to have my facial nerve damaged in this surgery is there chance of repair? Would it depend on the severity?
Hello.  The risk of facial nerve injury even in revision mastoid surgeries is less than 10 %. However, if there is cholesteatoma sitting on the facial nerve or facial canal is dehiscent, there is more susceptibility to FN (facial nerve) damage. Is there any prior facial weakness. Meticulous dissection of cholesteatoma ideally should not damage facial.  Even if there is damage and it is recognized intraoperatively, it can be corrected by various means. So yes there are techniques to deal with FND (facial nerve damage) if it occurs but the best to ensure it is not injured is to identify it and carry out meticulous dissection of the disease and remove the disease or leave the matrix over the facial as situation demands.