How long do you keep the mastoid dressing in case of post auricular incision.? Also in mastoidectomy cases when do u remove it?
When do you start ear drops ?
Do you ask your patients to perform valsalva ? When ?
Do you remove the gelfoam or allow it to resolve naturally ?
When do you repeat the audiogram?
Hi Kartik !
I can tell you from personal experience that the answers to your questions are :
no dressing if graft obtained retroauricular but keep dry
ear drops immediately
avoid water and valsalva until confirmation of graft taken- includes learning to sneeze with open mouth
Drops help gelfoam dissolve up to 3 weeks, do not remove as risk of injury to graft >>first few weeks. May need to remove some residual fragment when TM graft takes with gentle suction
Repeat audiogram after all gel resorbed /removed in about 6-8 weeks and graft taken.
On first followup visit the Weber test should be heard louder in the packed ear if any prior SNHL has resolved as AC is blocked.
Better yet, contact Dr Andrea Vambutas who is top ENT with extensive experience in this procedure at the "Northwell" rebranded 1-1-16 from NS-LIJ hospital system.
Dr. Andrea Vambutas is an ENT-otolaryngologist in New Hyde Park, New York and is affiliated with multiple hospitals in the area, including Long Island Jewish Medical Center and North Shore University Hospital. She received her medical degree from Albert Einstein College of Medicine of Yeshiva University and has been in practice for 23 years. She is one of 59 doctors at Long Island Jewish Medical Center and one of 56 at North Shore University Hospital who specialize in Otolaryngology.
Office Location & Contact
Lijmc-Dept. Of Otolaryngology
430 Lakeville Rd
New Hyde Park, NY 11042
Phone: (718) 470-7550
Fax: (718) 470-4281
: General Otolaryngology/ENT, Neurotology
Hello Kartik
I remove the dressing of the post auricular wound after forty eight hours to avoid any post operative soft tissue swelling/edema.
I remove the gel foams after two to three weeks in tympanoplasty cases.
Ear drops are used only if there is some infection or some discharge is seen otherwise I generally avoid using these ear drops till the graft becomes intact as they may help in causing the super added infection over the freshly placed graft material.
Tuning fork tests can be performed after the removal of the gel foams but the pure tone audiometry is done after three months. Valsalva is also avoided till the graft becomes healed.
remove Glasscock dressing (or mastoid dressing) 24 hours after surgery if no active bleeding has been noted (keep on additional 24 hours if there has been any noticeable bleeding into the dressing).
NO H2O in ear until healing is confirmed.
After dressing off, start gentamycin drops (3-4 gtts to packing surface BID) to moisten Gelfoam (avoid desiccation that will cause the Gelfoam to contract and potentially mobilize the graft); continue drops until follow up in +/- 12 days; remove loose, easily mobilized Gelfoam at first post op visit and decrease gentamycin drops to once QOD if TM is visible (should be); keep ear dry and follow up in 10 days. TM should be healed and easily visible by then.
- Badges
- Science topic
- Similar topics
- Chemistry
- Pharmacology
- Pharmaceuticals
- Drugs