Tympanoplasty eardrum surgery (2102)

Key points below

Your child needs surgery on their ear. This should help them to hear better. There may be a hole in the ear drum that needs to be patched. A cyst or infection might also need to be removed and cleaned out.

Understanding the surgery

There are 2 kinds of surgeries that your child might need. It could be that they will need both.

ear canal

Tympanoplasty

A tympanoplasty is a surgery to repair the eardrum. Sometimes surgery is needed on structures behind the ear drum. Most often it is on the small bones behind the ear drum that allow hearing. In some cases, surgery is done through the ear canal. Cuts (incisions) are made in the ear canal. In other cases, surgery is done from behind the ear. The incision is hidden behind the outer the ear. The kind of incision will depend on what repair needs to be done.

Mastoidectomy

A mastoidectomy removes a small amount of bone behind the ear canal to get to the mastoid space. This is an air-filled area that connects to the space behind the ear drum.This surgery is done through a cut (incision) that is hidden behind the outer ear.

Ear infections and cholesteatoma (skin cysts behind the ear drum) need both tympanoplasty and mastoidectomy to completely clear infection and the cyst. When these surgeries are done together, it is called tympanomastoidectomy.

Sometimes, a mastoidectomy is done alone. This would be for someone who gets a cochlear implant or to reach infection that is just in the mastoid bone and mastoid space.

How do I care for the ear after surgery?

The most important thing to remember is to keep the ear dry.

Your child may have a round, cup-like dressing over the ear that had surgery. There may also be a small cotton ball just outside the ear canal. These can be removed 24 hours after surgery. Your surgeon will let you know if this needs to be kept on longer.

Under the dressing and cotton ball, the ear canal is usually filled with dissolvable packing. This helps the ear canal and ear drum heal. Sometimes some of the packing will fall out. Do not worry, the packing does not need to be put back into the ear canal. Do not pull out loose packing. Let it dissolve or fall out on its own.

If your child has an incision behind the ear, keep the area completely dry for 48 hours after surgery. After this, you can allow soap and water to run over the wound. Do not scrub or soak the area.
It is very important to keep all water out of the ear canal. To do this, coat a cotton ball heavily with petroleum jelly and put it in the outermost part of the ear.
It is normal to see dark or blood-tinged drainage from the ear canal for up to a week after surgery. You may clean the crusting from the outer part of the ear with hydrogen peroxide. Sometimes you may see brown or dark red pieces of packing coming out from the ear canal. Do not try to replace or remove any packing in the ear canal.

How will my child feel after surgery?

Ear pressure or popping – Packing in the middle ear may cause “popping,”
“cracking”, or ringing noises. This will get better when the packing is removed or dissolves on its own.
Swelling and bruising – The area around the ear and eye may become slightly swollen and bruised. Check on it each day to make sure it’s not getting worse.
Taste changes – Some patients have a metallic taste or dryness on one side of the tongue. This may take a few weeks or even a few months to go away. Very rarely some taste change is permanent.
Ear numbness - Your child may lose some feeling in the skin in and around the ear for a while. This numbness may be the whole outer ear or only the top half.
Jaw symptoms - The jaw joint is in front of the ear canal. Some soreness or stiffness in the jaw can happen after ear surgery. It usually goes away in 1 to 2 months.
Dizziness- It is normal for your child to feel dizzy or lightheaded for up to one week after surgery. If your child gets very dizzy, let us know.
Nausea -Give a bland diet until appetite returns. Offer fluids, making sure your child pees once every 2 to 3 hours.

Home Care

Medicines

Your child may have slight pain in their ear. Follow your doctor's instructions for pain relief. A prescription for pain medicine may be given. Be sure to follow the label instructions carefully.

If your child has a bleeding disorder, do not give ibuprofen (also known as Advil or Motrin).

Your doctor may prescribe a stronger pain medicine. This medicine is called a narcotic. Some narcotics contain acetaminophen (Tylenol). If your child is taking a narcotic, check with your doctor before giving Tylenol.
Give the exact amount of medicine your doctor ordered.
When giving a narcotic, do not let your child do anything that needs balance when taking painkillers.
If the medicine is a liquid, use a measuring device to measure the exact dose. Ask the pharmacist for one. Do not measure liquid medicines in kitchen spoons.Stay with your child until they have swallowed the dose of medicine.
Store all medicine out of the reach of children.
If your child or someone else takes too much of this medicine, first call the Poison Center at 1-800-222-1222

If antibiotics or ear drops are prescribed, give them as directed until they are gone.

Special Instructions

Tell your child to sneeze with their mouth open. They should not try to hold the sneeze in. This avoids pressure build-up in the ear.
Do not let your child chew any gum or blow bubbles with gum for 2 weeks after surgery. This can build up pressure in the ears and cause the incision to open.
Keep your child from blowing their nose for at least 2 weeks after surgery. The pressure from blowing can cause the healing eardrum to move or shift. Sniffing is okay. After 2 weeks your child can gently blow their nose, one side at a time.

Activity

Your child may play quietly. Avoid active or rough play and contact sports, like football and soccer. Their surgeon will tell you when they are cleared to start again. This is often a few weeks after surgery.
No swimming until cleared by the surgeon.
Ask your doctor when your child may go back to school. This is usually after 1 to 3 days.
No heavy lifting or bending until your child sees the doctor. This will prevent pressure from building up in their head.
Avoid playing certain musical instruments, like wind instruments or a trumpet, until cleared by the surgeon.
No air travel until cleared by your doctor.

Follow-up Appointment

Call the ENT clinic at 414-266-2982 to schedule the follow-up visit, unless it is already scheduled.

For more health and wellness information check out this resource:

https://kidshealth.org/ChildrensWi/en/parents

ALERT

Call if you have any questions or concerns:

(414) 266 6461, ENT Nurse Triage Line your child is having problems or if your child has special health care needs that were not covered by this information.
(414) 266-2000, Hospital Operator if you have an emergency or if it is after hours. Ask for the ENT surgeon on call to be paged.
(414) 266 6461, Call the ENT Nurse Triage Line if:

Your child complains of a lot of pain even after taking pain medicine.
Your child is having problems or if your child has special health care needs that were not covered by this information.
You see a large amount of bleeding, puss or foul-smelling drainage coming from your child's ear.
Your child has a temperature of 101° F (38.3° C) or higher.
There is increasing redness in the ear area.
There is a difference in the way your child’s face looks or moves on the side of the surgery.
Your child is very dizzy.