Mastoid Tympanoplasty Post-Op Instructions

INSTRUCTIONS FOR POST-OPERATIVE CARE OF YOUR EARS TYMPANOPLASTY AND MASTOID TYMPANOPLASTY

Many of our surgical procedures are now done on an outpatient basis. These are general guidelines for many of our procedures, so not all items may pertain to you.

If your procedure is done from behind the ear, you may leave the hospital with a large dressing wrapped around the head which is secured by a Velcro strap. The following day, you may remove this at home simply by disconnecting the Velcro and unwrapping the dressing. You will remove the gauze, cotton balls, and telfa pad. Under all this will be some paper strips. These stay on for one week. At the end of the week, you peel these off. If they don’t peel readily, soak them in a little hydrogen peroxide and they should come off with ease. Your sutures will probably be under the skin and your body will absorb them. In some cases, we may use stitches which we will remove here in the office in approximately seven days.

The cotton ball in your ear should be changed as often as needed. It will absorb blood and drainage. This will gradually decrease, but some drainage may be present for several weeks. Several short gauze strips are placed in the ear canal under the cotton ball. Do not worry if these come out with the cotton balls. The important packing is deeper in the canal.

PACKING in the ear will be removed in the office by the doctor, either in 1 or 2 weeks, depending on what surgery you have had.

WASHING YOUR HAIR: Use caution when you wash your hair to keep the ear and incision dry. To accomplish this, coat a sterile cotton ball with Vaseline and put it in the ear. This will keep water from penetrating the packing. You will have to take some precautions to keep the incision dry.

There should be little pain following the surgery. We have given you a prescription for a pain medication in the event that Tylenol is not adequate. Do not take aspirin, Advil, Nuprin or similar compounds, as these increase the risk of bleeding. Your ear may be numb for approximately six months following surgery. Sometimes there is a slight taste disturbance or metallic taste post-operatively. This usually disappears in 3-4 months. Balance disturbance is usually minimal. You should not drive if you are taking pain medicine other than Tylenol, or if you have any dizziness.

CALL OUR OFFICE IMMEDIATELY if you should note any fever, excessive pain or pus-like discharge.

You will be seen in the office every few weeks until your ear is totally healed. We usually recommend yearly checkups with a hearing test thereafter.

If you have any questions or problems, please don’t hesitate to ask. Our medical assistant and nurse will answer your questions and communicate any problems to me. We hope this will help you make a smooth recovery from your surgery.

 

RISKS AND COMPLICATIONS OF TYMPANOPLASTY AND MASTOIDECTOMY

Tympanoplasty and mastoidectomy are procedures designed to remove infection from a chronically diseased ear and repair and rebuild the eardrum and little bones of hearing. The purpose of surgery can include:

  • Repair eardrum
  • Establish a clean dry ear
  • Remove infection or skin cyst (cholesteatoma)
  •  Improve hearing if possibleAlternatives to surgery include:
  • Cleaning, ear drops and antibiotics
  • Water precautions
  • Hearing aidYour ear problem may be helped by a tympanoplasty or tympanomastoidectomy. As with any surgery, there are not only potential benefits but also risks. There are also risks associated with deciding not to undergo surgery. All of the risks which are discussed below may occur as a result of an infection in your ear. With each infection, the damage to your ear and hearing may worsen. You must keep in mind that you may not benefit from the surgery and there is a slight chance your hearing may be worse after surgery. The following information will help you understand the results and risks of a tympanoplasty or tympanomastoidectomy. The substantial risks involved include, but are not limited to:

    HEARING: Although most of our patients experience a hearing improvement after surgery, some have the same hearing and a few have a further or complete loss of hearing. At times, a second procedure may be performed to attempt hearing improvement when the ear is badly diseased, or the hearing reconstruction is not initially successful.
    DIZZINESS: Dizziness may occur immediately following surgery due to swelling in the ear and irritation of the inner ear structures. Some unsteadiness may persist for a week post-operatively. Only rarely is dizziness prolonged in patients. TASTE DISTURBANCE: The nerve that supplies one third of the taste to the tongue runs through the middle ear and may have to be pushed aside or cut in order to do ear surgery. Therefore, temporary taste disturbance occurs in many of our patients and usually lasts about three months. It can last as long as one year. Permanent taste disturbance and dryness of the mouth occurs occasionally.

    TINNITUS OR RINGING: Ringing in the ear is often present in patients who have a hearing loss. Therefore, most patients already have ringing before surgery. After surgery, ringing is usually less but can be worse in rare cases.
    FACIAL NERVE PARALYSIS: The facial nerve controls movement on one side of the face and runs through the middle ear and mastoid bone. A temporary paralysis Is possible due to swelling or bruising of the facial nerve, but has occurred in very few of our patients. We monitor the facial nerve function closely during surgery. If a severe injury to the nerve occurs, a residual weakness will remain permanently.

    PERFORATION: Closure of an eardrum perforation is the main goal in most ear surgeries. Nearly all of our patients have an intact eardrum after surgery, but not all patients heal perfectly and the hole may reappear in rare cases. A post- operative perforation can usually be repaired at a second revision procedure.
    INFECTION: The chance of infection clearing after surgery is very high. In some cases, a two-stage operation is necessary especially if a cholesteatoma (skin cyst in the ear) is found.

    ANESTHESIA: Any questions you may have regarding the risks and complications involved with anesthesia should be discussed with the anesthesia personnel at the hospital where surgery is scheduled.

Disclaimer: These Post-Operative Instructions are for patients of record at our practice only. If you are not a patient of Ear Consultants of CNY, please contact your own surgeon for specific instructions.