Diet
In the immediate postoperative period, you may experience vertigo, nausea, and/or vomiting. Therefore it is preferable to stick to a liquid diet or a light bland meal. A regular diet may usually be resumed on the 1st or 2nd day after surgery assuming the nausea is improved. It is quite common to have some difficulty opening the mouth in cases where an incision is made behind the ear (postauricular incision) – this is related to cutting through the temporalis muscle (a muscle that helps to move the jaw) to access the ear. This usually improves within 2-3 weeks.
Wound care
The operated ear will be packed and full of blood. It will feel clogged and you may hear some crackling sounds. The temple and the region around the orbit (eye socket) may be swollen. Sometimes, you can have bruising of the eye on the same side and bruising down the face in the 1-2 weeks after surgery.
If there was an incision behind the ear (postauricular incision), you will usually have a dressing that puts pressure on the ear. Take off this dressing on the 2nd postoperative day. After you take this off, you will probably have a nonadhering dressing over the incision. Under this are tapes (steri-strips) and/or stitches. There will also, in most cases, be a cotton ball in the outer hollow of the ear.
The tapes behind the ear should be left in place until they fall off on their own. When they fall off, apply antibiotic ointment (bacitracin) twice daily to the incision.
The cotton ball can be changed as needed for bleeding or drainage. After the ear stops bleeding and draining, you don’t have to keep a cotton ball in the ear.
In cases where a meatoplasty was done (to make the ear opening bigger) – such as in a canal wall down tympanomastoidectomy or other surgeries to make an ear canal or widen the ear canal, there may be sponges in the ear. Leave these sponges in place – they will usually be removed 2-3 weeks after surgery
You can start the antibiotic drops into the operated ear on postoperative day 2-3. Use about 5 drops into the ear twice daily until you are seen postoperatively. If there are sponges in the ear, use the drops directly on the sponges. If there is packing in the ear canal, use the drops directly on the packing.
Sometimes, packing will fall out on its own. It is ok if this happens. Don’t attempt to put the packing back in and never attempt to clean your ear with q-tips or other instruments.
Besides using the drops, keep water out of the ear. In the shower, place a cotton ball in the outer hollow of the ear and smear vaseline all over the cotton ball so that it is sealed from the water in the shower. You can also consider a shower cap if you are not washing your hair. Some patients have purchased little mini shower caps that just go over the ear.
Other activities and precautions
Avoid hard nose blowing for several weeks after surgery – if you blow your nose too hard, it can translate the pressure to the grafted eardrum and potentially cause it to fail.
Sneeze with your mouth open. Never stifle a sneeze – even if you did not have ear surgery.
Flying is usually not advised until at least 6 weeks after surgery. Please discuss with your surgeon if you need to fly around the time of surgery.
Sleep with the operated ear up if you can for several weeks after surgery.
Please avoid strenuous activity or heavy lifting over 20 lbs for at least 2 weeks after surgery.
Do not go swimming after surgery unless cleared by your surgeon. Even after you are cleared, if you had a tympanoplasty/mastoidectomy, it still may be advisable to use waterproof earplugs when swimming.
Please take all medications as prescribed after surgery. Pain medication can be taken as needed. If you are given antibiotics, please finish all of them, but please call if you have an adverse reaction to them. If you are given steroid (prednisone), please take with food in the morning. If you had severe nausea or dizziness after surgery, you may also be prescribed anti-nausea medication.
Please call if you have severe swelling in the area of surgery, an abnormally large amount of bleeding that keeps saturating the dressing within a few hours, severe vertigo, severe tinnitus (ringing of the ear) – soft or moderate tinnitus can often be normal after surgery, severe pain not controlled by pain medication, or fever over 101 degrees F.
Brian Kung, MD 