STAPEDECTOMY, TYMPANOPLASTY OR MASTOIDECTOMY
STAPEDECTOMY: A stapedectomy is a procedure in which a tiny bone in the middle ear, the stapes, is removed and prosthesis (artificial ear bone) is inserted to help restore hearing. A stapedectomy is recommended when a bony growth forms around the tapes, restricting the normal movement of this bone. This limited movement interrupts sound waves to the inner ear creating a conductive infection. A stapedectomy is performed first in the ear with the greatest hearing loss. Any patient who is told that a stapedectomy will restore their hearing has the option of wearing a hearing aid instead.
TYMPANOPLASTY: A tympanoplasty is a procedure in which the doctor places a tissue graft (a tiny patch of skin), across a hole in the tympanic membrane (the Eardrum), to allow the hole to heal. A hole may have been formed as a result of trauma or infection. This procedure is usually successful in repairing the hole and improving your hearing.
MASTOIDECTOMY: A mastoidectomy is a procedure used to remove an infection or cyst (cholesteatoma) that is located in the mastoid and/or eardrum. The mastoid is a bone, which lies around the ear, and when damaged, your hearing can be impaired. A mastoidectomy and tympanoplasty is recommended to repair the damage and restore hearing.
The following BEFORE AND AFTER instructions can help you obtain the best possible results from your surgery. If you have any questions, please call one of the nurses. Make sure your questions are answered before surgery!
RISKS AND COMPLICATIONS OF SURGERY
The following are the possible complications and risks associated with this procedure. In addition to those listed below, there may be some unforeseen complications with any surgical procedure.
1. DIZZINESS: Some unsteadiness is common during the first few postoperative days: dizziness on sudden head motion may persist for several weeks. On rare occasions dizziness is prolonged.
2. TASTE DISTURBANCE AND MOUTH DRYNESS: This is not uncommon for a few weeks after surgery. In 5% of patients this disturbance is prolonged.
3. TINNITUS: Tinnitus (ringing, swishing or other type of noise that seems to originate in the ear or head), may occur following surgery and is usually temporary.
4. LOSS OF HEARING: Further hearing loss develops in 2% of patients due to complications in the healing process. In less than 1% of patients this hearing
a. Loss is very severe and may prevent the use of a hearing aid in the operated ear.
RISKS AND COMPLICATIONS OF SURGERY cont.
1. EARDRUM PERFORATION: A perforation (hole) in the eardrum membrane develops in less than 1% and is usually due to an infection. Fortunately, the membrane may heal itself. If healing does not occur, surgical repair may be required.
2. PARALYSIS: A very rare complication of stapedectomy and tympanoplasty is paralysis of the face. This may occur as the result of injury or swelling of the facial nerve. This weakness on that side of the face is usually temporary, but some long term weakness may result.
1. Tell your doctor all the medications and herbal supplements you are taking. This includes both prescription and over the counter medications.
2. DO NOT take any aspirin containing products for ____ weeks before and ____ weeks after surgery. Some arthritis medication and drugs like Advil, Motrin, Ibuprofen and Aleve act like aspirin and should NOT be taken. These medications may cause increased bleeding during and after surgery. It is okay to take Tylenol during this time period.
If you are taking Aspirin, Coumadin or Plavix special instructions as noted below will apply:
You will need to stop your Aspirin _____ days before surgery or on _____ and resume your Aspirin ____ days after surgery or _____.
You will need to stop your Plavix _____ days before surgery or on _____ and resume your Plavix ____ days after surgery or _____.
You will need to stop your Coumadin _____ days before surgery or on _____ and resume your Coumadin ____ days after surgery or _____.
3. If you develop a cold or any other infection during the two days prior to surgery, please notify our office immediately. The doctor may or may not prescribe an antibiotic instead of postponing your surgery.
4. Plan to spend 7-10 days away from work or school after surgery. This time frame is provided as a guideline since each individual’s recovery time will vary. Please postpone out of town plans for two weeks after surgery.
NIGHT BEFORE SURGERY
DO NOT EAT ANYTHING AFTER MIDNIGHT UNLESS INSTRUCTED TO DO SO BY THE ANESTHESIOLOGIST. IF YOU EAT AFTER MIDNIGHT YOUR SURGERY MAY BE CANCELLED!!
1. Continue to drink fluids (clear liquids only) up until ____ am/pm. Clear liquids consist of: water, apple or cranberry juice (no orange juice), Gatorade, Chicken Broth, Coffee or tea but no cream or sugar, popsicles and jello. You will feel much better on the day of surgery if you drink clear liquids up until the 4 hours before your scheduled surgery time. Then nothing to drink after ____ am/pm.
2. OK to take important medications with a small amount of water the morning of surgery.
3. Remove all nail polish and make-up.
4. Get a food night’s rest.
5. Wear loose comfortable clothing.
Arrange to have a responsible adult drive you to the surgery center and stay with you at home on the night of your surgery. That responsible adult MUST stay in the waiting room until you have been discharged back to them. (You are NOT allowed to drive yourself home)
1. DO NOT PUSH ANYTHING INTO THE EAR DURING YOUR RECOVERY!!!
2. Severe dizziness (vertigo) and nausea may be experienced for 2-4 days as the delicate mechanism that controls balance may have been temporarily disturbed.
3. You can expect to have ear packing and a dressing in place. During the first 24 hours after surgery, the dressing may become saturated with blood. If this occurs, do not remove the dressing, just reinforce the bandaged area by adding gauze dressing. If bleeding seems excessive, contact your doctor. After 24 hours remove the dressings. If you have stitches, using a Q-Tip soaked in peroxide, clean the sutured area twice a day. Then apply an over the counter antibiotic ointment to the suture line. Keep the suture area dry when showering by covering with plastic and taping it in place.
4. You will most likely experience popping and crackling sounds inside your ear due to the absorption of the ear packing and the opening and closing of the Eustachian tube. This is normal.
5. Improvement in hearing will probably not be evident for several weeks after surgery.
1. ANTIBIOTICS: Your physician may or may not prescribe an antibiotic. If you are given a prescription, please take it as directed until you finish the supply. This is important in wound healing and in preventing infection. You will NOT need a refill.
2. PAIN MEDICATION: The pain medication that is prescribed is usually Tylenol based with a narcotic, so you may experience some drowsiness. You should NOT go to work or school, nor drive a car as long as you are taking the pain medication. Your pain medication should be taken as directed, but DO NOT exceed the prescribed dose. If severe pain persists, please call the office. Watch for constipation from the pain medication.
YOU MAY WISH TO EAT A LITTLE SOMETHING BEFORE YOU TAKE YOUR PAIN MEDICATION. IF NOT YOU MAY DEVELOP AN UPSET STOMACH. Suggestions: Yogurt, Applesauce, Saltine Crackers.
3. ANTI-NAUSEA MEDICATION: You may or may not have been given a prescription for suppositories to alleviate the nausea. If you were not given a prescription and you experience nausea and/or vomiting, please call the office.
4. Avoid alcoholic beverages as long as you are taking prescription medications.
5. DO NOT take Aspirin, Motrin, Advil, Ibuprofen or Aleve for 2 weeks after surgery. These products can thin the blood and may cause bleeding.
Refills must be approved by your doctor. Plan ahead and allow the office 48 hours to refill your prescription. Be sure to mention any drug allergies, as well as the name and location of the pharmacy at the time of your refill request.
ACTVITIES AND COMFORT MEASURES:
1. Rest with head slightly elevated on 2-3 pillows for the first couple of days.
2. DO NOT BLOW YOUR NOSE, AVOID SNEEZING AND VIOLENT HEAD MOVEMENTS. If you must sneeze, keep your mouth open.
3. You may take a bath or shower the following day after surgery. You must keep the inside and outside of the ear very dry. Use a cotton ball, covered with Vaseline, to make a waterproof seal in the ear. This cotton ball must be placed gently inside the bowl of the outer ear. Take special care to keep your ears dry when washing your hair for at least 6 weeks.
4. During the first week, quiet indoor activities are recommended.
5. NO heavy lifting, straining, athletic activities or sports for 2 weeks. DO NOT stay bent over for prolonged periods.
6. A low grade fever of 99.9-100.9F is common. To help control your fever, drink plenty of fluids. If the fever exceeds 101.5, call the office during business hours.
1. Slowly progress to full liquids and then soft foods such as pudding, cream soups, ice cream, etc. then to a regular diet as tolerated. Your fluid intake is very important throughout your recovery.
FOLLOW UP APPOINTMENT:
The doctor will want to see you 7-10 days after surgery. Your follow up appointment will be made before you are discharged home on the day of surgery. If an appointment was not made or if you need to reschedule, please call our office.
REASONS TO CALL YOUR DOCTOR AFTER HOURS:
1. Fever of 101.5 degrees or greater. (only call during business hours)
2. Increased bleeding or drainage from incision site.
3. Severe pain not relieved by medication.
4. Vomiting 2 or more times in one day, After the first 24 hours
5. Difficulty breathing or swallowing.
6. Welts, Hives or Rashes that appear after taking prescription medication(s).
*If you need to reach the Doctor for an urgent medical issue after hours please call our office number (385-7272). Select option #7 to reach the on call doctor.