SOUTHWESTERN EAR, NOSE & THROAT

SANTA FE OFFICE: 982-4848

SURGERY CENTER: 982-7761

Dr. David Brown     Dr. Paul Kaufman     Dr. Peter Shepard     Dr. Thomas Thomason    

STAPEDECTOMY

A stapedectomy is a procedure in which a tiny bone in the middle ear, the stapes, is removed and a prosthesis (artificial ear bone) is inserted to help restore hearing.  A stapedectomy is recommended when a bony growth forms around the stapes, restricting the normal movement of this bone.  This limited movement interrupts sound waves to the inner ear creating a conductive hearing loss.  This gradually deteriorating hearing loss is usually without any middle ear infection.  A stapedectomy is performed first in the ear with the greatest hearing loss.  Any patient who is told that a stapedectomy will restore their hearing has the option of wearing a hearing aid instead.

RISKS AND COMPLICATIONS OF SURGERY

The following are the possible complications and risks associated with this procedure.  In addition to those listed below, there may be some unforeseen complications with any surgical procedure.

¨      DIZZINESS: Some unsteadiness is common during the first few postoperative days; dizziness on sudden head motion may persist for several weeks.  On rare occasions dizziness is prolonged.

¨      TASTE DISTURBANCE AND MOUTH DRYNESS: This is not uncommon for a few weeks after surgery.  In 5% of patients this disturbance is prolonged.

¨      LOSS OF HEARING:  Further hearing loss develops in 2% of patients due to complications in the healing process.  In less than 1% of patients this hearing loss is very severe and may prevent the use of a hearing aid in the operated ear.

¨      TINNITUS: Tinnitus (ringing, swishing or other type of noise that seems to originate in the ear or head), may occur following surgery and is usually temporary.

¨      EARDRUM PERFORATION: A perforation (hole) in the eardrum membrane develops in less than 1% and is usually due to an infection.  Fortunately, the membrane may heal itself.  If healing does not occur, surgical repair may be required.

¨      PARALYSIS: A very rare complication of stapedectomy is paralysis of the face.  This may occur as the result of injury or swelling of the facial nerve.  This weakness on that side of the face is usually temporary, but some long term weakness may result.

The following BEFORE and AFTER instructions can help you obtain the best possible results from your surgery.  If you have any questions, please call one of the nurses. Make sure your questions are answered before surgery!!!

BEFORE SURGERY

1.                  Tell your doctor all the medications and herbal supplements you are taking.  This includes both prescription and over the counter medications.

If your primary physician/specialist has placed you on Aspirin, Plavix or Coumadin please inform your surgeon for specific instructions.

2.                  If you develop a cold or any other infection during the two weeks prior to surgery, please notify our office immediately.  The doctor may or may not prescribe an antibiotic instead of postponing your surgery.

3.                  Plan to spend 7 – 10 days away from work or school after surgery.  This time frame is provided as a guideline since each individual’s recovery time will vary.  Please postpone out of town plans for two weeks after surgery.

NIGHT BEFORE SURGERY

¨      DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT UNLESS INSTRUCTED TO DO SO BY THE ANESTHESIOLOGIST.   IF YOU EAT OR DRINK AFTER MIDNIGHT, YOUR SURGERY WILL BE CANCELLED!!!  Continue to drink fluids up until midnight.  You will feel much better on the day of surgery.

¨      Remove all nail polish, make-up and jewelry (watches, earrings,  all body piercings, necklaces, etc).

¨      Get a good night’s rest.

¨      Wear loose comfortable clothing.

Arrange to have a responsible adult drive you to the surgery center and stay with you at home on the night of your surgery. That person MUST stay in the waiting room until you have been discharged back to them.  (You are NOT allowed to drive yourself home).

AFTER SURGERY

¨      Severe dizziness (vertigo) and nausea may be experienced for 2 - 4 days as the delicate mechanism that controls balance may have been temporarily disturbed.

¨      You can expect to have packing inside your ear that will dissolve.  If there is any left, it will be removed at your post op visit.

¨      You will most likely experience popping and crackling sounds inside your ear due to the absorption of the ear packing and the opening and closing of the Eustachian tube.  This is to be expected.

¨      Improvement in hearing will probably not be evident for several weeks after surgery due to the ear packing.

Medications:

¨      ANTIBIOTICS: Your physician may or may not prescribe an antibiotic. If you are given a prescription, please take it as directed until you finish the supply.  This is important in wound healing and in preventing infection.  You will NOT need a refill.

¨      PAIN MEDICATION: The pain medication that is prescribed is usually Tylenol based with a narcotic, so you may experience some drowsiness.  You should not go to work or school, nor drive a car as long as you are taking the pain medication.  Your pain medication should be taken as directed, but do not exceed the prescribed dose.  If severe pain persists, please call the office.

YOU MUST EAT A LITTLE SOMETHING BEFORE YOU TAKE YOUR PAIN MEDICATION, IF NOT YOU WILL PROBABLY VOMIT.  Suggestions: Yogurt, Applesauce, Saltine Crackers.

¨      ANTI-NAUSEA MEDICATION: You may or may not have been given a prescription for suppositories to alleviate the nausea.  If you were not given a prescription and you experience nausea and/or vomiting, please call the office.

¨      Avoid alcoholic beverages as long as you are taking prescription medications.

¨      Please follow instructions given to you by your surgeon regarding Aspirin, Plavix or Coumadin.

¨      Refills must be approved by your doctor.  Plan ahead and allow the office 48 hours to refill your prescription.  Be sure to mention any drug allergies, as well as the name and location of the pharmacy at the time of your refill request.

ACTIVITIES AND COMFORT MEASURES:

¨      Rest, with head slightly elevated on 2-3 pillows is encouraged for the first couple of days.

¨      DO NOT BLOW YOUR NOSE; AVOID SNEEZING AND VIOLENT HEAD MOVEMENTS.  If you must sneeze, keep your mouth open.

¨      During the first week, quiet indoor activities are recommended.

¨      NO heavy lifting, straining, athletic activities or sports for 2 weeks.  DO NOT stay bent over for prolonged periods.

¨      A low grade fever of 99.9-101.0 F is common.  To help control your fever, drink plenty of fluids.  If the fever exceeds 101.5, call the office.

¨      You may take a bath or shower 1 day after surgery.  You must keep the inside and outside of the ear very dry.  Use a cotton ball, covered with Vaseline, to make a waterproof seal in the ear.  This cotton ball must be placed gently inside the bowl of the outer ear.  Take special care to keep your ears dry when washing your hair for at least 6 weeks.

DIET:

¨      Slowly progress to a regular diet as tolerated. Your fluid intake is very important throughout your recovery.

FOLLOW UP APPOINTMENT:

The doctor will want to see you 7 - 10 days after surgery.  Your follow up appointment will be made before you are discharged home on the day of surgery.  If an appointment was not made or if you need to reschedule, please call our office.

REASONS TO CALL YOUR DOCTOR:

¨      Fever of 101.5 degrees or greater.

¨      Severe headache or ear pain not relieved by medication.

¨      Vomiting 2 or more times in one day, after the first 24 hours.

¨      Difficulty breathing or swallowing.

¨       Welts, Hives or Rashes that appear after taking prescription medication(s).

¨       Excessive bright red bleeding.

¨       Prolonged dizziness.

¨       Facial nerve paralysis.