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Postop Myringoplasty / Mastoidectomy

Postop Myringoplasty / Mastoidectomy

POSTOPERTIVE INSTRUCTIONS AFTER MYRINGOPLASTY OR MASTOID SURGERY

  • Usually there will be an overnight stay.

  • In some cases, particularly with an operation time earlier in the day, and a smooth recovery, same day discharge may be possible.
  • Up to 2 weeks will be required to fully get over the procedure, depending on the extent of surgery, and the unique healing process of each individual patient.
  • For most people, it is possible to get back to work significantly before the 2 week mark, ultimately when they feel well enough.
  • After smaller myringoplasty procedures, it is not uncommon to be functioning normally the next day.

PAIN RELIEF

  • Pain is not usually a major feature of this surgery. The following regime is used, as required:
  1. PANADOL 1g 4 X day
  2. CELEBREX 200mg 2X day or NUROFEN 400mg 3X day
  3. Endone 5mg every 4 hours as required
  • The extent of pain depends on how extensive the operation was.

  • If there is a cut behind the ear (rather than an operation down the ear canal) or extensive drilling of bone, pain might be more severe.
  • Some patients can experience significant dizziness in the early postoperative period.
  • Fortunately, for most people the pain is quite manageable.

POSTOPERATIVE CARE

Dressings

  • There may be a head bandage which is removed on the first postoperative day.
  • If the operation was down the ear canal, the only dressing will be a small piece of cotton wool at the outside of the ear canal.
  • It is not unusual to get some light yellow, or bloodstained discharge in the early postoperative period.
  • The cotton wool dressing can be changed whenever it becomes moist or discoloured, which may be up to twice per day.

Packing

  • The deep part of the ear canal is usually packed with a dissolving dressing called gelfoam.
  • There are usually 2 small pieces of antiseptic impregnated ribbon gauze just outside the gelfoam.
  • Cotton wool will sit just outside the ribbon gauze, and may need to be changed 1-2 X a day, if it becomes moist or discoloured.

Stitches

    • If there is a cut behind the ear, the stitch is usually under the skin and dissolving (and does not require removal).
    • If there is a cut in front of the ear , or inside the ear canal, the stitches are usually dissolving, and don’t require removal, but may need to be trimmed.

POSTOPERATIVE VISITS

  • At the first postoperative visit, the ribbon gauze is removed, and the patient will be started on regular antibiotic drops.

  • The ear will be suctioned to remove of residual packing material at 4 weeks.
  • It is usually evident at this stage if the operation has been successful.
  • When the canal has been drilled, more frequent reviews may be required, as there are potential issues with postoperative scarring which can be minimised with appropriate early intervention (breaking down scar tissue, and stenting with a wick)

FLYING

  • From the available evidence, it is probably safe to fly even in the early postoperative days.
  • Having said this, there is a chance of Eustachian blockage which could compromise the fragile ear drum and graft.
  • Ideally, flying is avoided for 6 weeks.