John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What are the general instructions and follow-up care?
An appointment for a follow-up ear check-up should be made 10 to 14 days after the procedure. At this visit, the position and function of the tubes will be assessed.
Usually, two different types of ear drops will be given to you the day of surgery. Cortisporin ear drops (or its generic equivalent) are to be used immediately after surgery for three days (3-4 drops each ear 3 times per day). If there is drainage from the ear after three days, continue to use the drops until the day before your office visit or as per doctor's instructions. Discontinue these drops if they cause severe pain or a skin rash develops.
You may substitute
sulfacetamide/prednisolone (Vasocidin) drops if any of these problems develop. Vasocidin drops are used in the ear if water accidentally enters the ear canal. This will help prevent water contamination related ear drainage. Vasocidin drops are actually an eye medication, but are prescribed as a safe medication for the ears. Both drops should be warmed by holding them in the hand for five minutes and inserting into the ear canal along the side. You can "pump" them into the ear by pushing on the soft cartilage tissue located in front of the ear canal (medically termed the tragus).
Ear drainage may occur immediately after the procedure or at any time while the tubes are in place. Yellow clear fluid or mucous may drain for several days to weeks after the surgery. It is not unusual to see a bloody discharge following surgery. Cotton can be kept in the ear canal and changed as needed to keep dry. If after the immediate post operative period, profuse, foul-smelling discharge drains from the ear, an infection is the possible cause. If this occurs, begin by using ear drops for three days. If the drainage continues beyond three days, call the doctor to determine if additional medicine and/or an office visit is necessary.
Conventional medical advice is that water should not be allowed to enter the ear canal while the tubes are in place. Because there is now a passage into the middle ear to allow for ventilation, water can also pass into the middle ear space. If this occurs, ear drainage and infection may follow. However, there is some controversy as to whether this poses a significant risk, and many otolaryngologists disagree on the need for water protection. There is an increased risk of infection in lake or pond water, as opposed to chlorinated water found in swimming pools. Follow your doctor's advice regarding water precautions.
Your doctor may recommend utilizing ear plugs whenever there is a chance of water contamination (swimming, bathing, washing hair). Bathing caps or "ear bandits" are also helpful.
Tympanostomy tubes usually stay in place from 6 to 18 months. If they stay in longer than
two to three years, they may need to be surgically removed. It is important to have an ear check-up about every six months during this time period. An audiogram is usually obtained at some point after the ear has healed. The tubes eventually fall out of the eardrum on their own as the ear heals. Some children may have mild discomfort or bloody drainage at this time. The small hole in the eardrum at the old tube site usually heals within several weeks. Your doctor will instruct you when it is safe to allow water in the ears.
The Eustachian tube is a membrane lined tube that connects the middle ear space to the back of the nose. Problems include partial or complete blockage which can cause popping, clicking, and ear fullness. Allergies, sinus and ear infections, or the common cold can cause this blockage, while altitude changes can cause symptoms in those persons with Eustachian tube problems. Treatment includes several maneuvers (swallowing, chewing gum, yawning etc.), which can be done to improve Eustachian tube function.
Ear was is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
A common form of short stature, achondroplasia (dwarfism) is a genetic condition causing a disorder of bone growth. Complications of achondroplasia that need monitoring include (this is not all inclusive) stenosis and compression of the spinal cord, a large opening under the skull, lordosis, kyphosis, spinal stenosis, hydrocephalus, middle ear infections, obesity, and dental crowning. Achondroplasia is caused by mutations of the FGFR3 gene.
Cleft palate and cleft lip are facial and oral defects that occur early in pregnancy. A cleft lip is a split of the two sides of the upper lip, and a cleft palate is a split in the roof of the mouth. Cleft lip the fourth most common birth defect in the U.S. Repair of a cleft palate or cleft lip may require multiple surgeries.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
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