Tympanoplasty Post Operative Instructions

Tympanoplasty operation

Dressing: have to be changed on the 2 nd and 10 th / 17 th day.

Ear Drops: Wash the inside of the ear by filling the ear with Boric Spirit ear drops and immediately emptying it out. Then put in 4 drops of Decadron ear drops + 4 drops of Nuflucon (Eye) drops and shake them up inside the ear by in and out movements of a finger placed on (not in) the ear. Plug the ear with a large clean cotton wool ball soaked in Neosporin H ointment. Do not push this deep in ear canal. Repeat this morning and evening. Continue this for 3 months.

The drops will gradually dissolve away the Gelfoam placed in the ear. This is yellowish in colour and looks like discharge; do not be alarmed.

After 3 months stop using Nuflucon and Decadron drops but continue Boric Spirit ear washes twice a week for another 3 months.

Auto Inflation Exercise

On the 45 th day of the operation start autoinflation exercise. Repeat daily for 6 months except during a cold. Pinch your nose and try to blow air out through the nose with nose held tight. Air should enter both the ears with a sound like a slight click, but not like air whistling out through a hole. The idea is to move the drum everyday but not to blow a hole in the drum. The amount of force required to be used to move the drum varies from patient to patient.

If you do not move the drum regularly daily for 6 months it will get stuck and the hearing will not be perfect. If you blow too hard or do this exercise during a cold you might blow a hole in the drum.

Precautions:

Do not do autoinflation exercise if you have a cold- nasal discharge must not be forced up into the ear.

Do not blow nose during a cold – nasal discharge must not be forced up into the ear.

Do not worry by a noise like fluid in the ear, it is not pus but Gelfoam, a jelly like dressing placed on the drum.

Do not let water enter the ear for 12 months.

Use cotton ball day and night.

Do not worry if there is a red spot on the bandage. This is blood stained medicine and not bleeding.

There should not be severe ear pain or swelling around the eye. If there is, bandage is probably too tight. You should come over to have it loosened.

DIET: Full Avoid Iced food and drinks which might induce a cold.

Travel: No long distance bust travel for 4 days after this operation

AUDIOGRAM 2 YEARLY.

Air Travel after Ear Surgery

Air travel is not advisable for 6 weeks after Tympanoplasty operation because of the negative pressure in the ear during descent of the plane. Even after this period, the following precautions should be observed.

1. Do not fly during a cold because the pressure equalization function of the Eustacian Tube connecting the nose to the ear is impaired during a cold.
2. Do not sleep during decent of the plane.
3. Chew Chewing-Gum during descent because the act of swallowing saliva opens the Eustacian tube
4. Avoid exposure to loud sounds.
5. Use for 2 days before and after an air journey:

•  Otrivin nose drops – 2 drops – 3 times daily

•  T. Levarid – D tablet – 1 time daily

Important Instruction after Ear Surgery:

1. After completing the course of medicines prescribed, if you develop a cold, take:

(i) Otrivin nose drops – 2 drops – 3 times daily

(ii) Actified ½ tablet – 2 times daily

1. On 17 th day open the dressing yourself at home. (Do not go to a doctor)
2. Boric spirit drops prepared here should be used. (Outside Boric spirit should not be used as the distilled water, bottle and droppers are not sterile)
3. Cotton ball should be steralised in a pressure cooker before use
4. Apply Neosporin-H ointment on the cotton ball. Do not push the cotton ball deep inside the ear.
5. While taking a head-bath after the bandage is removed put a big cotton ball and a towel on the operated ear, keeping the operated ear downwards.