Mendy Maccabee, MD performsTympanoplasty through the ear canal to patch any holes in the ear drum and evaluate the bones that carry the sound from the eardrum to the inner ear. The eardrum is lifted up and a tissue graft is placed beneath the old eardrum to allow healing. A piece of dissolvable packing is used in the middle ear and ear canal to keep the graft in place. You may have an incision and dissolvable sutures behind your ear if we cannot do the surgery completely thru your ear canal.
BEFORE SURGERY: No aspirin, Motrin, Ibuprofen, Advil, or any other anti-inflammatory medicine for one week before and one week after surgery. Also avoid Vitamin E, herbal supplements, herbal teas, and red wine for one week prior to surgery. Tylenol is permitted at any time. If you take Coumadin or other blood thinners please discuss this with your surgeon. Please do not eat or drink anything after midnight the night before surgery, but you may take any prescription medicines the morning of surgery with a sip of water and brush your teeth. The hospital or surgical center will call you the day before with time and instructions for surgery. Make arrangements for a ride home after surgery. You will not be able to drive yourself home from the hospital.
PAIN: There is usually very little pain after this surgery. If this is done on a child, your child may be fussy or irritable after surgery. A sore throat and ear discomfort are normal. Give pain medications as directed and encourage fluid intake.
HEARING: Decreased hearing over the first 4-6 weeks after surgery is common as there is dissolvable dressing and ointment filling the ear canal. The hearing will improve over time. We will have you start using some ear drops 2-3 weeks after surgery to help dissolve the packing.
DRAINAGE: A bulky pressure dressing is placed over the ear for the first day or two. After this is removed, the only dressing will be a cotton ball in the ear canal covered with ointment. There may be some ear drainage for a few days after surgery. A small amount of blood/drainage is common. You may see some old blood or scabs come out of the ear. The drainage may soak partially through the dressing the first night. Call your doctor if the bleeding is continuous. Change the cotton ball twice a day always covered with ointment (Bacitracin, Neosporin, etc.). If you don’t put ointment on the cotton ball, the ear packing may stick to the cotton ball and be pulled out too early, possibly destroying the ear drum graft.
TASTE: There may be a funny or metallic taste in the mouth if the nerve to the front part of the tongue was stretched or cut. This nerve usually heals quickly if stretched. It is sometimes cut deliberately if necessary, but the loss of this nerve is usually not noticed at all after several weeks.
BATHING/SHOWERING: You can bathe or shower, but you should keep the ear dry. Using a cotton ball that has been coated with ointment can do this. The coated portion should be placed loosely into the ear canal, sealing the ear canal from the water. The doctor will tell you when it is ok to get your ear wet again after surgery.
ACTIVITY: Avoid strenuous activities for at least 2-3 weeks after surgery. Adults should not drive a car while on the pain medication. Do not blow your nose or sneeze with your mouth closed for 2 weeks, as this could destroy the ear drum graft. It is better to sniff or dab the nose if it is running. Avoid flying or major altitude changes for two weeks.
WHEN TO CALLTHE DOCTOR: Excessive bleeding—please do not take aspirin or Motrin (Advil or Ibuprofen) for one week before or two weeks after surgery. Dizziness is common immediately after surgery. If this persists more than 72 hours after surgery this could be a sign of an inner ear problem. Persistent nausea/vomiting. Temperature over 101.5. Drainage from the wound worsens. Uncontrolled pain. Signs of dehydration—if the patient has had little or no intake of fluids for 12 hours or a child seems particularly irritable or has not urinated for 8 or more hours.
RISKS: The biggest risk of this surgery is that the graft could fail, meaning another surgery could be required. This often happens because of nose blowing or other sudden pressure changes in the ear such as flying or forcing a sneeze or cough through the nose and ears. Avoid pressure changes for two weeks after surgery. Hearing damage or deafness. Scarring in ear canal or on ear drum causing hearing loss. Cyst formation in or behind ear drum, needing further surgery. Change or loss of sense of taste. Temporary or permanent facial weakness or paralysis. Need for second stage reconstruction of your hearing bones.
GENERAL INFORMATION • DO NOT drive, make important decisions, use power tools, drink alcohol, tend children, or climb ladders for the first day or two after surgery. Your judgment or alertness is probably seriously impaired. • Fainting or lightheadedness may occur. Use caution and move slowly when getting up from a bed or chair. • Avoid strenuous activities or lifting any object heavier than 20 pounds for the next 2-3 weeks. Avoid bending at the waist as much as possible. These may contribute to bleeding. • Call our office with any questions or concerns. • In case of emergency go to the nearest Emergency Room or call 911.
FOLLOW UP APPOINTMENTS: You will need a follow up appointment 7-14 days after surgery. You should have this appointment scheduled before you leave your pre-operative appointment. If you do not have an appointment already please have them schedule one for you before you leave the hospital after surgery.
Additional Patient Instructions
- General Preoperative Instructions
- Allergy Drops – Sublingual Immunotherapy (SLIT)
- Allergy Shots – Subcutaneous Immunotherapy (SCIT)
- SLIT vs. SCIT Efficacy
- Asthma Action Plan
- Neck Disection Instructions
- Parathyroidectomy Risks and Benefits
- Laryngoscopy Post-Op Instructions
- Submandibular Gland Excision Post-Op Instructions
- Instructions For Collecting a 24hr Urine Specimen
- Ear Tubes
- Ear Tubes with Tonsil and Adenoid Surgery
- Endoscopic Sinus Surgery
- Parathyroid Surgery information
- Nasal Fracture Closed Reduction - Broken Nose
- Mupirocin and Budesonide Irrigation