What is an ossiculoplasty?
The middle ear has three tiny bones known as malleus, incus and stapes (collectively known as the ossicles) that vibrate along with the eardrum to conduct sound from outer ear to inner ear. A disease affecting the middle ear can damage these three bones and affect your hearing. The reconstructive surgery to restore this bone conducting mechanism is called an ossiculoplasty.
The biggest benefit of an ossiculoplasty is functional restoration of the ear’s sound conduction mechanism which in turn leads to improved hearing ability.
The ENT surgeon partially or completely repairs the ear’s sound conducting mechanism by either augmenting or reconstructing the damaged ossicles. He can use either harvested ossicles or artificial prosthetics made of teflon, hydroxyapatite, or titanium etc, to accomplish this repair work. The remaining part of this surgical procedure is quite similar to that of myringoplasty (detailed above). ENT surgeons often combine ossiculoplasty with myringoplasty in a single procedure.
Just like the preoperative instructions, the postoperative instructions for ossiculoplasty too are very similar to those for a myringoplasty.
First 24 hours:
Take complete bed rest. Do not lie on the side of the operated ear.
You are not allowed any drink or food till 4-5 hours after the surgery. After the surgical staff gives the go-ahead, you can sip water. A while later you can take milk or Horlicks etc. However, caffeinated beverages such as tea, coffee or aerated drinks are to be avoided as these can cause gastric irritation when consumed on an empty stomach. You can start a semi-solid diet in moderate quantities after 12 hours. You can resume normal food from second day onwards.
Precautions from the day of discharge:
- Take all medications on schedule as prescribed by your surgeon.
- Do not oil your hair.
- Do not clean your ear.
- Stay away from people with cold or cough.
- Do not blow your nose with excessive force.
- If you have to sneeze, do so with your mouth open.
- Do not have a head bath for a full one month after the surgery. No water should get into your ear.
- Do not sleep on the operated side for a month afterwards.
- Do not undertake strenuous work for a month afterwards.
- Do not travel by air for 3 months after the surgery.
The following activities are allowed:
- A daily bath that does not wet or spoil your head bandage till the time it is on your head.
- Resumption of regular office work after 3 days of surgery (unless specially advised by your operating surgeon)
When you should contact the hospital immediately:
- If your prescription medicines cause any drug reactions such as rashes or stomach upset etc, call your doctor immediately.
- If your ear bandage becomes loose or gets soiled between days 1 and 7 i.e. from operation till suture removal, visit your doctor for a fresh bandage.
Precautions after suture removal:
- Strictly follow all the dos and don’ts mentioned above.
- Change the cotton outside the ear three times a day using the method demonstrated to you by the hospital staff.
- Clean behind your ear while bathing.
- Disregard low to moderate ear discharge as it is a normal occurrence for up to 3 months after the surgery. But keep an eye open for excessive ear discharge.
- A follow-up audiological evaluation is advised 3 months from the date of surgery.
When you should contact the hospital immediately:
- If you get any severe pain in the ear or surrounding region.
- If you get any swelling in or around the ear.
- If you feel dizzy or are vomiting.
- If you feel facial weakness.
- If your ear is oozing excessive discharge.
Timeline for specific activity resumption:
- Head bath: 1 month after surgery
- Office work/ housework: 3 days from the date of surgery (your ear bandage will stay on for 7 days)
- Air travel: 1 month after surgery
- Swimming and other water activities: 3 months after surgery
After surgery and subsequent discharge from the hospital, the following post-operative visits with your operating surgeon will be scheduled:
- 7 days later for suture and ear bandage removal (1st visit)
- Following first visit, visits every 10 days in the first month (2nd & 3rd visits)
- Visits every 15 days in the second and third month (5th to 8th visits)
- One visit every 3 months for the rest of year
- One visit every 6 months from the second year following the surgery
Ossiculoplasty conducted by an expert surgeon delivers very successful outcomes.
While ossiculoplasty rarely leads to any complications, still like any other surgery, it carries some risks that you should know prior to giving consent to this treatment. Please consult your surgeon for further risk evaluation in your individual case.
- Taste disturbance: The taste nerve runs close to the eardrum and may sustain some damage to cause abnormal taste on one side of the tongue. While this taste disturbance is mostly a temporary phenomenon, it may be permanent in some cases.
- Dizziness: Dizziness for a few hours after the surgery is normal. In some cases, it may last longer.
- Hearing loss: Very rarely, if the patient’s inner ear is damaged, severe deafness can occur.
- Tinnitus: If the hearing loss worsens, the patient may suffer from tinnitus or noises in the ear.
- Facial Paralysis: As the facial nerve controlling face muscles runs through the ear, there is a slight chance of a partial or total facial paralysis affecting movements such eye closure, smiling and raising the forehead. This facial paralysis can occur immediately after the surgery or after a while. Recovery can be partial or total.
- Allergic reaction to ear dressings: Occasionally the ear may show allergy to the dressings in the ear canal leading to a red, swollen and inflamed pinna (outer ear). Consult your surgeon for dressing removal and settling down of the allergic reaction.
- Risks of a general anaesthetic must also be kept in mind.