Major Ear Surgery – Post-Operative Care Instructions
This advice relates to: myringoplasty, atticotomy, tympanoplasty, mastoidectomy, canalplasty/osteoma/exostosis, ossiculoplasty, and stapedotomy surgery
These ear surgeries are usually performed as a day case (you return home the same day), under a general anaesthetic (you will be fast asleep).
If an incision has been made behind your ear then you will wake with a head bandage. This is to stay on overnight. You should remove the bandage and all the padding beneath this the morning after surgery, so that you are just left with paper stickers (Steristrips) covering the incision (which has been closed with absorbable sutures – there are no stitches to remove).
If the surgery had been performed solely through the ear canal, or if grafts have been taken from the ear canal, there may be some stitches visible just in front of the ear. These are dissolvable and will brush off with time. They do not need to be removed.
There will often be a cotton ball within the ear canal. This can be replaced if required. If there is bleeding from the ear canal, keep replacing the cotton ball - the bleeding is normal and harmless, and will eventually settle. The cotton ball can be left out after a day or two. Deep to this are some antibiotic-soaked ribbon packs that are to stay in, to hold the ear drum and canal skin in place whilst it heals. If any of the ribbon packing falls out, do not replace it - there will always be packs deeper in the canal holding things in place.
After 5 days you can get the wound behind the ear wet and soak off the Steristrips, but the ear canal needs to be kept dry - you can use a cotton ball coated in Vaseline in the ear canal whilst having a shower. The ear canal needs to be kept dry for the first month.
Take analgesia as required, such as regular paracetamol or co-codamol, and ibuprofen.
You should not swim or fly for two months following your surgery.
If there are any complications contact the ward, my secretary, your GP or even A&E if it is an emergency. The ward can issue more analgesia, reapply head bandages, review wounds, and manage suspected minor infections. They will contact the surgeon for advice if required.
You will receive a follow-up appointment for 2 to 3 weeks following your operation. At this point the ear canal packing will be removed, the canal cleaned, the wound checked, and antibiotic:steroid ear drops issued. A further follow-up appointment will be arranged for approximately 2 months’ time with a hearing test on arrival. It is only at this appointment will we know whether the ear drum has healed, and the state of your hearing.
Risks of Major Ear Surgery
Myringoplasty (to repair the eardrum) D1420
Bleeding, infection, scar, pain, temporary altered taste, failure/recurrence (10%)
(Overnight) headbandage and ear canal packing may be required, plus shaving small patch of hair behind ear
No swimming or flying for 2 months post-op
Combined Approach Tympanoplasty (CAT) D1440
Bleeding, infection, scar, pain, temporary altered taste, recurrence/need for further imaging/surgery, facial weakness, dizziness, hearing loss, numbness, tinnitus
(Overnight) headbandage and ear canal packing may be required, plus shaving small patch of hair behind ear
No swimming or flying for 2 months post-op
Modified Radical Mastoidectomy (MRM) D1020
Bleeding, infection, scar, pain, temporary altered taste, recurrence/need for further imaging/surgery, facial weakness, dizziness, hearing loss, numbness, tinnitus
(Overnight) headbandage and ear canal packing required, plus shaving small patch of hair behind ear
No swimming or flying for 2 months post-op
Revision mastoidectomy/revision of mastoid cavity D1060
Bleeding, infection, scar, pain, temporary altered taste, recurrence/need for further imaging/surgery, facial weakness, dizziness, hearing loss, numbness, tinnitus
(Overnight) headbandage and ear canal packing required, plus shaving small patch of hair behind ear
No swimming or flying for 2 months post-op
Canalplasty (to widen the bony ear canal) - for exostoses: D0280; all others: D0342
Bleeding, infection, scar, pain, perforated ear drum, hearing loss, numbness, tinnitus, facial weakness (very rare), recurrence/need for further surgery
(Overnight) headbandage and ear canal packing required, plus shaving small patch of hair behind ear
No swimming for 2 months post-op
Excision ear canal osteoma D0812
Bleeding, infection, scar, pain, perforated ear drum, hearing loss, numbness, tinnitus, recurrence/need for further surgery
No swimming for 2 months post-op
Meatoplasty (to widen the cartilaginous ear canal) D0340
Bleeding, infection, scar, pain, recurrence/need for further surgery, ear canal packing
No swimming for 2 months post-op
Atticotomy (OPCS4.7 Other operations mastoid D1220)
Bleeding, infection, scar, pain, temporary altered taste, recurrence/need for further imaging/surgery, facial weakness, dizziness, hearing loss, numbness, tinnitus
(Overnight) headbandage and ear canal packing may be required, plus shaving small patch of hair behind ear
No swimming or flying for 2 months post-op
Ossiculoplasty/Ossicular Chain Reconstruction (OCR)/Partial Ossicular Replacement Prosthesis (PORP)/Total Ossicular Replacement Prosthesis (TORP) D1610
Bleeding, infection, scar, pain, temporary altered taste, partial/no improvement in hearing, facial weakness, dizziness, hearing loss, numbness, tinnitus
(Overnight) headbandage and ear canal packing may be required, plus shaving small patch of hair behind ear
No swimming or flying for 2 months post-op
Stapedotomy D1710
Bleeding, infection, scar, pain, temporary altered taste, facial weakness, dizziness, hearing loss (1% total), partial/no improvement in hearing, numbness, tinnitus, need to abandon procedure depending on findings
Ear canal packing required
No swimming or flying for 2 months post-op