Tuesday September 2, 2014

Dr. Logan, Loucks & Taylor: 2841 New Hartford Road  ~ Owensboro, KY 42303 ~ (270) 691-6161 ~ Hours: Mon-Fri 8:30 am - 5:00 pm


Dr. Mumford: 922 Triplett Street ~ Owensboro, KY 42303 ~ (270) 926-4175 ~ Hours: Mon-Fri 8:30 am - 5:00 pm

 

Tympanomastoidectomy

 

The ear is a very delicate organ responsible for both hearing and balance. The mastoid cavity is a pocket of air cells within the bone behind the ear that can sometimes become chronically infected. On occasion, recurrent infections will result in a hole in the eardrum. The hole may then result in additional  ear infections, ear drainage, and ear pain. Sometimes an abnormal growth called a cholesteatoma can form in the mastoid cavity or the space behind the ear drum. This is a benign growth that can do a lot of damage to the ear and can result in chronic infection. As the cholesteatoma grows it can erode the normal tissues including the bones of hearing or the balance center.


A tympanoplasty is the surgical correction of a hole in the eardrum. Under certain circumstances attention will also be turned to the bones of hearing to ensure appropriate mobility and continuity of the bones. A mastoidectomy is the opening of the mastoid cavity to eliminate the chronically infected tissues and to reduce the occurence of future infections. If a cholesteatoma is present, this will be removed at the same time.


The surgery is performed through the ear canal and through an incision behind the ear. Under most circumstances, tissue from the patient’s ear will be harvested and used to reconstruct the hole in the eardrum. If the bones of hearing need to be reconstructed, a surgeon may use native tissue such as bone or cartilage or possibly a prosthesis made from synthetic material.


Complications from Tympanomastoidectomy:
Potential complications include bleeding from the ear, infection of the ear, and potentially complete loss of hearing. Dizziness is a common complaint immediately after surgery but is usually short-lived and will resolve during the normal healing process. On a rare occasion hearing loss and dizziness can be a long term complication. Under most circumstances, a general anesthetic will be used which also can cause potential complications.


The facial nerve runs through the ear and mastoid cavity and can sometimes be damaged by the chronic disease process or from the surgical procedure. This can result in a facial weakness or paralysis. This is an uncommon complication of mastoid surgery. When it occurs it is usually temporary but can be permanent. OMHS has the latest in monitoring devices that are used during the surgery to make the surgery as safe as possible.


Not all tympanoplasty procedures are successful. A small percentage of patients who undergo the surgery will have a persistent hole in the eardrum even after the surgery, as a result of the body’s inability to use the graft to heal itself or due to chronic infectious processes which may limit normal healing. Following your physician’s postoperative instructions is the best way to ensure adequate healing after surgery.


Postoperative Instructions:
• Elevate the head of the bed on the day of surgery.
• Limit all activities: No heavy lifting, no exertion.
• Keep the ear and all incisions clean and dry after the surgery (do not attempt to wash your hair until instructed to do so by your surgeon).
• A dressing may be placed on the ear. You will be instructed on how to care for the dressing.
• A drain may be placed behind the ear and will be removed during your first postoperative visit.
• Do not blow your nose for at least two weeks following the surgery.
• Limit swimming for six weeks following the surgery.
• Limit airplane travel for six weeks following the surgery.
• It is not uncommon to miss 7-10 days of school or work.


Postoperative Expectations:
• Nausea, vomiting and dizziness are very common complaints after the surgery, especially on the day of surgery due to the general anesthetic.
• A low grade fever (up to 101°) is common following surgery.
• The patient will experience muffled hearing for up to three month after the surgery.
• There may be a slight amount of bleeding for the first day or two following the surgery.
• There may be drainage from the ear for several weeks.


Financial Responsibility:
Insurance policies represent agreements between you and your insurance provider. As a courtesy, OMHS will file your insurance claims for you and allow a reasonable time for payment. You are responsible for payment of services not authorized by your insurance provider.


Always Bring With You:
• Doctor’s orders or papers given to you by your doctor, including this brochure.
• Medication bottles or a complete medication list with dosages and times. This includes prescription and over-the-counter medications such as aspirin, Tylenol, ibuprofen, vitamins, herbs and diet pills.
• Insurance cards.
• Any recent EKG, X-Ray or laboratory results you may have already had performed. This may prevent repeat testing.
• A copy of your Living Will, Medical Power of Attorney documents or guardianship papers, if applicable.


Before Surgery:
• Call your physician if you become ill (fever, chest congestion, flu) or if you can’t keep your scheduled surgery appointment.
• Tell your doctor if you have any allergies, including latex.
• Tell your doctor if you are taking any blood thinners, diabetes medications or diet pills.
• Stop taking any herbal medications or diet pills.
• Stop smoking.
• Notify your insurance company of your surgical plans even if your physician’s office has done so.
• If your doctor discussed donating your own or your family member’s blood before surgery, call Western Kentucky Regional Blood Center at 684-9296.
• If it is not possible to visit the OMHS Pre-admission Center, call their office at 270-688-1125 the day before your surgery.


The Night Before Surgery - DO NOT:
• DO NOT eat or drink anything after midnight, unless instructed by your physician. This includes water, coffee, gum and mints.
• DO NOT drink alcoholic beverages for 24 hours before surgery.
• DO NOT eat spicy or heavy foods for dinner the night before your surgery.


On the day of Surgery - DO:
• Take only those medications (with a few sips of water) as instructed by your physician and/or preadmission nurse.
• Take a complete bath or shower.
• Wear loose, comfortable clothing.
• Bring your cases for contact lenses, glasses or dentures to be stored during your surgery.
• Remove your contact lenses prior to surgery.
• Have a responsible adult available to drive you home and remain with you for 24 hours following the surgery. The medications you may receive will make it unsafe for you to drive a car, walk home or travel by public transportation.
• Please bring a responsible adult with you but limit visitors. Outpatient Surgery limits visitors to two per patient. Until the nurse has prepared you for surgery only one person will be allowed.
• A parent or guardian must accompany any patient 17 years of age or younger.
• Arrive 2 hours before your scheduled surgery time, unless otherwise instructed by your physician or Pre-Admission nurse. Go directly to the Outpatient Surgery Department on the 2nd floor.
• Bring your C-PAP machine to the hospital if you use one during sleep.
• Bring currently used inhalers with you.
• Bring any information provided by the surgeon or the preadmission nurse.


On the day of Surgery - DO NOT:
• DO NOT smoke or at least reduce the number of cigarettes you smoke in the 12 hours prior to urgery. Smoking can increase your risk of complications and the amount of pain you have after surgery. Smoking cessation is recommended 6 weeks before surgery for maximum benefits/risk reduction.
• DO NOT wear make-up, jewelry, body piercings or contact lenses.
• DO NOT wear nail polish or artificial nails.
• DO NOT bring valuables.
• DO NOT eat or drink.
• DO NOT bring children under the age of 12 with you.

 
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