New York Eye and Ear Infirmary
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What to Expect Before Ear Surgery

Pre-operative Evaluation

All patients who are potential candidates for ear surgery should undergo a complete head and neck examination and review of their most recent computerized tomographic images (CT scans) as part of their pre-surgery consultation. 

The patient’s physical findings, in particular the ear findings, and the CT scans should be reviewed with the patient. We recommend the use of the patient’s actual CT scans and an ear diagram as the best method to describe the indications for surgery and the actual operative procedures. 

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Informed Consent

Well-informed patients are better able to participate in their own care.

Patients, or their legal guardian, must consent in writing to the proposed surgical procedures. We recommend that this be performed at the time the patient is considering surgery, and that the consent convey the risks, rewards, alternatives and potential complications.

Download a copy of the consent form.

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Pre-testing

All patients should undergo a complete history and physical examination within weeks of their planned surgery. We recommend that this be performed by the patient’s own physician because they know the patient best, are the best able to alter pre-operative medications, and can alert the surgeon to potential problems. 

Guidelines for pre-operative testing following the recommendations of the American Society of Anesthesiologists are as follows:

Healthy patients <40 years

CBC, SMA-7

Healthy patients <40 years who smoke

CBC, SMA-7, EKG, Chest x-ray

Healthy patients >40 years

CBC, SMA-7, EKG, Chest x-ray

 

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Pre-operative Medications

As a generalization, patients should avoid all medications, which increase bleeding 10 to 14 days prior to surgery. Aspirin is the most common such drug. Other medications which increase bleeding are: 

Analgestic (Pain) Tablets Cold/Cough Preparations

Alka-Seltzer Effervescent
Anacin
Arthritis Pain Formula
Arthritis Strength Bufferin
Aspirin
ASA Compound
Ascriptin, Ascriptin A/D
Aspergam
Athropan Liquid
Buffaprin
Bufferin
Ecotrin
Emperin Compound
Excedrin
Fiorinal, Fiorinal Compound
Goody’s Headache Powder
Measurin
Motrin
Phenaphen
Pyrroxate
Vanquish

Alka-Seltzer Plus
Bayer Children’s Cold Tablets
Bayer Decongestant
Congespirin
Contact
Coricidin
Dristan
Sine-Aid
Sine-Off
St. Joseph Cold Tablets for Children
Super Anahist
Triaminicin
4-Way Cold Tablets

Sedatives (Sleep) Tablets Holistic & Homeopathic Medications

Cope
Dolcin
Dolor
Duragesic
Emagrin
Excedrin PM
Fizrin Powder

As the safety and side effects of these agents is frequently unknown or unclear, they should be discontinued prior to surgery.

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Patients with a history of stroke or heart valves, often require anti-coagulation therapy and the pre-operative cessation of these medications should be coordinated between the internist and surgeon.

What to Expect the Day of Ear Surgery

Pre-admission

Plan to be admitted to the hospital approximately two hours prior to surgery. 

Those patients undergoing surgery at the New York Eye and Ear Infirmary of Mount Sinai (main telephone number 212-979-4000), should register in Admitting which is located on the first floor on main building at 310 East 14th Street (corner of 14th Street and 2nd Avenue). 

All pre-operative testing, and paper work, will be in the Admitting Office and will accompany the patient to the Day Surgery Unit. If the patient has pre-operative ear CT scan, these should be brought to the Day Surgery Unit and given to the nurses to convey to the surgeon.

View maps, directions and parking for the The New York Eye and Ear Infirmary

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Day Surgery Unit

While awaiting surgery, the patient will visit with their anesthesiologist, and discuss their medical history and prior anesthesia history. If the patient has a history of adverse reactions to anesthetics or other medications, it is essential to communicate this to the physicians and nurses.

All prior records are very helpful. While awaiting surgery, the nurses will review with the patient all pre-operative records, confirm the nature of the proposed surgery, and administer any required pre-operative medications.

As a safety precaution, both the nurses and physicians will repeat the same questions in both the Day Surgery Unit and operating room.

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Family Members

Family members should wait for the patient on the same floor as the patient was admitted. For adults, this is usually the fifth or seventh floors, and the ninth floor for children. Please communicate to nursing where family members are waiting so that the surgeon can discuss with them the outcome of the operation and arrange follow-up care.

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Post-operative Hospital Care

Most patients will be observed for two or more hours after surgery in the Day Surgery Unit. Patients must be alert, stable and capable of drinking clear liquids as minimum for discharge.

Prior to discharge, the nurses and physicians will observe the patient to insure that they are well and are properly prepared for discharge. Some patients are observed in the hospital overnight. 

Patients are often discharged with a dressing around the head and your surgeon will discuss with you the arrangements to remove the dressing.

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Discharge from Hospital

At discharge, the patient should have a prescription for all post-operative medications, know when to return to see their surgeon, know who to call in case of emergency (212-979-4200) and what to do after surgery. 

These items will be discussed with the patient by nursing, and are reviewed under What to Expect After Surgery. Patients should not drive themselves home, and should have arranged transportation. 

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What to Expect After Ear Surgery

  1. You will not be able to hear well out of the operated ear for around 4-6 weeks after the surgery. In some instances, the hearing may actually be worse than before surgery. You may hear your voice louder in that ear or you may hear noise, crackling, or popping.

  2. There may be some pain after the surgery. This will improve over 24-48 hours.

  3. You may have an altered sense of taste on the same side of surgery. This will resolve over the next few weeks.

  4. You will have packing inside the ear canal. This will remain in the ear until your surgeon takes it out.

  5. There may be some discharge from the ear canal. You may want to keep a cotton ball in the ear for a few days, and change it as necessary.

  6. After the dressing comes off, the operated ear may stick out a little more than the other side. This will resolve over the next few weeks.

  7. You may have some mild imbalance or dizziness for a few days post-operatively. This will resolve.

  8. A low-grade fever (<101°F) is not uncommon.

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What to Do After Ear Surgery

  1. You will have a prescription for Tylenol #3. Take 1 to 2 tablets every 4 hours as needed for pain. After 1-2 days, Tylenol or Extra Strength Tylenol should be sufficient.

  2. Take the antibiotic prescribed as directed for the full course. If you get diarrhea or a rash, contact your physician.

  3. Keep the ear dry. When taking a shower, put a cotton ball smeared with Vaseline in the ear canal to prevent water from getting in. You may take a shower after the dressing comes off.

  4. Do not strain, lift heavy objects, work-out, or blow your nose until your surgeon gives you permission. You cannot fly in an airplane for approximately 4-6 weeks after surgery.

CALL THE OFFICE (212) 979-4200 IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING:

1. If you notice any weakness of the face.

2. If the dizziness becomes very severe.

3. If you experience any sensitivity to light associated with severe headaches and fever.

 

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About the Author

Content provided by the American Academy of Otolaryngology-Head and Neck Surgery
www.aao-hns.org

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