Initial wound care instructions
- Keep head wrap dressing on for 24 hours after surgery.
- Keep healing cap on until your post-operative checkup in the ENT clinic.
- Keep the wound/cap free from water until post-operative checkup.
- Keep incision line clean if visible around the gauze.
After the cap is removed
- Clean the incision daily with a cotton swab and hydrogen peroxide to
remove debris.
- Apply prescription ointment daily or as prescribed.
What to expect after surgery
- Possible dizziness.
- No lifting anything over 10 lbs. for at least two weeks.
- Sneeze with your mouth open.
- You will return to clinic 1-2 weeks after surgery for a post-operative
wound check.
Call our clinic if you experience any of the following:
- The cap comes off.
- Drainage that persists.
- Swelling.
- Increased pain.
- Fever of 101.5 ºF or higher.
Cleaning once dressings are removed:
Once the dressing has been removed and the abutment is exposed, you must clean the skin around the abutment every few days, as debris may build up. The best way to do this is while you are washing your hair, as shampoo and warm water will help to soften any crust that may have built up around the base of the abutment.
For the first few weeks you may use a strip of a baby wipe around the area to clean until you are able to gently brush the area with the Entific soft cleaning brush. Aim the bristles against the side of the abutment - not at the skin - as care must be taken not to brush the skin too harshly. The debris build up is not a scab and must be removed. Build up may also occur inside the abutment itself, so you need to clean inside as well as around. Any type of soap or shampoo can be used, but antibacterial soap is recommended.
After cleaning, gently dry the area around the abutment with a clean towel or baby wipe. Do not allow your hair to wrap itself around the abutment. If you use a hairdryer, do not keep the hot air on the abutment for too long. Remember to keep the Entific soft brush clean.
- Keep head wrap dressing on for 24 hours after surgery.
- You may shower and wet the wound 48 hours after surgery.
- Be gentle with the skin overlying the implant and incision line.
- Apply antibiotic ointment over incision line twice a day.
- Watch for drainage or swelling
Call our clinic if you experience any of the following:
- Drainage that persists
- Progressive swelling
- Increased pain
- Fever of 101.5 ºF or higher
These instructions are designed to help you care for your ear(s) following surgery, and to answer many of the commonly asked questions. Feel free to call us with questions or concerns you may have. If our medical assistant cannot address your concerns, a doctor will return your call or you may be asked to come to the office.
Home Care
- You will receive a prescription for pain medicine and sometimes an anti-nausea medicine and antibiotics.
- The bandage should be removed the day following surgery.
- The auricle (outer ear) can be wiped gently with a soft cloth or cotton swabs to remove dried blood, but if the ear is tender this is not necessary.
- You may wash your hair 72 hours after surgery.
- The incision behind the ear may be covered a thin layer of antibiotic ointment. Neosporin®, Polysporin®, Bacitracin®, etc. is helpful for the first few weeks.
- Do not bend over for 1 week after surgery. If you must bend, bend from the knees, not head-first from the hips. This will prevent pressure build-up in the head.
- Do not blow your nose for 1 week after surgery. Sniffing is okay. This is particularly important should you develop a cold. After 2 weeks you may blow your nose gently, one side at a time.
- Sneeze or cough with your mouth open during the first week following surgery.
- You may fly 3 days following surgery. Whenever you fly, take an over-the-counter decongestant 30-60 minutes before take-off. Before the airplane begins to descend, spray your nose with Neosynephrine® or Afrin® nasal spray. Use this procedure whenever you fly in the future. You may use the same treatment when traveling by car in a mountainous region.
- No vigorous physical activity, including sports, until seen for your post-op visit. With the exception of these restrictions, you may return to work or school as overall condition permits.
- After 3 weeks you may resume all activities, including sports and physical exercise while adhering to the restrictions recommended by the implant manufacturer.
- You may hear a variety of noises in your ear such as cracking or popping. This is part of the normal healing process.
- Dizziness or lightheadedness is normal for up to one week after surgery.
- Tinnitus (ringing in the ear) is also noted by some patients. This may improve with time.
- Pain should begin to subside. You may continue taking Tylenol® or ibuprofen as needed.
- It is normal for the top half of the ear to feel numb, and will take several months to return to normal.
- There may be a change in taste (usually described as metallic) on one side of the tongue – this usually improves within a few months.
Call the office if you experience:
- Increased pain not relieved by prescription medicines.
- Large amounts of bleeding for the ear area.
- Pus/foul-smelling drainage from the ear or incision.
- Redness in the ear area.
- Temperature over 101.5 °F on two consecutive readings.
- Severe dizziness.
Discomfort
Pain is usually not a problem after tube insertion. Tylenol® may be given to handle any discomfort, which generally won’t last more than the day of surgery.
Drainage
Drainage is normal after tube insertion, and usually tapers within a few days of surgery. Bloody drainage is not uncommon either.
Ear Plugs
While the tubes are in the ear, they need to be kept dry for at least one week following surgery. You can resume swimming in chlorinated water after this time period. Ear plugs or Vaseline® soaked cotton balls need to be used for baths or any other type of water. Earplugs are available at our office or at most drugstores, and due to the low cost, we recommend trying them first. If they don’t fit well, then custom earplugs can be fitted by our audiologists. Please contact our office for more information.
Ear drops
Eardrops will be given to you after the surgery. Typically, 3 drops are given 3 times a day for 3 days. The ear canal is not straight, so for children, pull the ear down and back to straighten the canal before placing the drops. You can also push on the cartilaginous structure in front of the ear canal to make sure the drops reach deep in the ear.
Diet
Normal diet may and should be resumed following surgery.
Fever
Contact our office with any temperature of 102º or higher.
Follow-up
Follow-up in about 4 weeks after surgery. After this, we will see you back every 6 months. If any questions or concerns arise, please contact our office.
Discomfort
Levels vary from patient to patient. You will receive a prescription for narcotic pain medication. Discomfort usually dissipates once the splints inside the nose are removed; therefore one week off work is usually sufficient.
Bleeding
You may experience some bloody discharge, which is normal postoperatively. Use a gauze pad under your nose to collect the blood. It’s not uncommon to change 3 gauze pads an hour until the next day. If you are concerned, please call. If packing has been used in your nose to control bleeding, please ask your physician how long it needs to stay in. Drink plenty of liquids to stay hydrated.
Diet
Start with clear liquids, advance to soft and then a general diet as tolerated.
What not to do
Do not blow your nose. Sneeze only with your mouth open to prevent shifting of the septum during this critical period of healing. No aspirin or ibuprofen for a week after the surgery unless another doctor insists that you need it. No contact sports, and try not to bump your nose for 2 weeks while the healing takes place. Complete healing usually takes up to 6 months to occur but most of the strength of healing occurs in the first few weeks.
Irrigation
Please purchase an over the counter saline flush from your local pharmacy or from our clinic. Please to irrigate your nose 2-3 times a day. Begin irrigating the morning after surgery, as it is critical to the healing process.
Fever
Contact our office with any temperature of 102° F or higher.
Activity
Light activity for one week. No lifting over 10 pounds.
Follow up
Follow up in about ~7 days for splint removal. As always, call with questions, problems, or concerns.
Activity
Take it very easy for 72 hours following your surgery. Plan on light activity for two weeks. Do not lift over 10 pounds or bend down (such that the head is below the heart) for 2 weeks.
Discomfort
Discomfort levels vary from patient to patient. You will receive a prescription for narcotic pain medication that will be needed for 2-3 days. Most people need a minimum of 3 days off work with a maximum of one week due to discomfort. Avoid aspirin and NSAID’s (such as ibuprofen) for 2 weeks unless discussed with your doctor, as bleeding and/or polyp formation may occur.
Nasal Congestion
For the first week after surgery, your head will feel stuffy and your nose obstructed. This is normal because of postoperative swelling of the mucous membranes of your nose, which will gradually decrease over the next few weeks. Nasal packing and/or splints may or may not be left in place after surgery. If you do have packing/splints, you will need to follow-up in our office for removal per your doctor’s instructions within two weeks of your operation.
Nose Blowing
DO NOT blow your nose for the first 10 days following your surgery. If you need to sneeze, do so with your mouth open. The walls between your eye and sinuses are very thin and elevated air pressure may blow air into the tissue around your eye and cause it to swell. The air will absorb, so there is no treatment needed.
Eye Symptoms
Eye ointment used in surgery is greasy and may cause temporary blurring of vision. If the tissue around your eye turns black and blue, and/or you have severe pain, contact our office. Vision problems (loss of vision, double vision) are rare events which would demand an immediate call to your doctor.
Forehead pressure
If you had image guided (computer assisted) surgery, then a frame was placed snugly around your forehead and it may be sore or red where the suction cups were placed.
Drainage
You may experience some bloody discharge, which is normal postoperatively. Use a gauze pad under your nose to collect the blood. It is not uncommon to change 3 gauze pads an hour for the first 24-48. If you are concerned, please call. If you get profuse, clear nasal drainage from one side of the nose, try to collect it in a cup and call (this could be the fluid that surrounds your brain, a very rare complication).
Irrigation
You will need to flush your nose with saline 2-3 times a day. Begin irrigating the morning after surgery, as it is critical to the healing process and minimizes crusting and obstruction.
Diet
Start with clear liquids. Once this is tolerated, advance to soft foods then a regular diet. Your throat might be sore from the breathing tube for a few days.
Fever
Contact our office with any temperature of 101.5 °F or higher, particularly if associated with a severe headache and/or neck stiffness.
Follow-up
A return visit will be needed 1-2 weeks after surgery. Please make sure that you have an appointment scheduled with your physician to make sure the sinuses are healing properly and to remove any packing or debris. As a general rule, you can expect three to five visits during the first two months after surgery. As always, call with any questions, problems or concerns.
Care in the first 72 hours following surgery
Standing and walking is desirable, reducing risks of blood clots and lung infections. Maintaining elevation of the upper body (30 degree angle is optimal) minimizes pain, swelling and bruising. An ice pack used at the surgical site (i.e., 15-30 minutes per hour) is also recommended.
After the first 72 hours
Light activity and work may be resumed. During the first 10 days following surgery, strenuous activity and exertion must be avoided, and the head and neck should always remain above the gravity level of the heart. Activities may thereafter be gradually advanced as tolerated.
Medications to avoid
Do NOT use aspirin, ibuprofen or similar non-steroidal anti-inflammatory medications including Pepto-Bismol® and Alka-Seltzer® in the first week following surgery unless recommended by your doctor.
Pain
You may use the narcotic pain medication issued by your surgeon at the time of surgery ONLY in the doses recommended. You may transition to plain Tylenol® (acetaminophen), but do not use Tylenol and the narcotic at the same time unless discussed with your doctor. Adults with healthy livers should not exceed 4000mg of acetaminophen daily; inform your doctor if you suffer from liver disease.
Neck swelling
Mild to moderate bruising and swelling are expected at the operative site. You should not have severe swelling or bruising or a sudden increase in pain and swelling postoperatively (contact physician).
Breathing
Stridor (noisy inspirational breathing) or shortness of breath are always abnormal, and require physician contact if mild or a 911 call if severe.
Symptoms of low blood calcium (hypocalcemia)
Include numbness and tingling around the mouth, on the face and in the extremities. More severe symptoms can include muscle spasms and cramping, particularly in the forearm and foreleg, and difficulty breathing. If you notice symptoms of low blood calcium, chew and swallow 4 TUMS® tablets (500mg each) and follow with a glass of orange juice, Gatorade® or water (as available, in that order), and immediately call your doctor. If symptoms are severe, call 911 after following the above instructions.
Follow up
Your surgeon will want to see you for a postoperative appointment. He may ask you to have specific laboratory studies (blood work) drawn postoperatively to check on hormone or calcium levels.
Incision care
Your wound may be closed with dissolvable sutures which are buried under the skin surface. Dissolvable sutures do not require removal. The skin is sealed with sterile tissue glue. If a surgical drain was used, the site must be kept dry. The day following surgery or drain removal, showering is permitted, but do NOT soak in a tub for 14 days following your operation.
REMEMBER TO ALWAYS CALL 911 IN A POTENTIALLY LIFE THREATENING EMERGENCY! A RIDE WITH THE PARAMEDICS IS A SMALL PRICE TO AVOID A CATASTROPHE.
Anatomy
The tonsils and adenoids are lymphoid tissues that help fight infections in the back of the throat. This is why they get big when you have tonsillitis. If the tonsils need to come out, there is still plenty of lymphoid tissue to fight infections in your throat.
Surgery
The surgery takes about 15-30 minutes under general anesthesia and can be done in an outpatient or inpatient setting. After surgery, you will taken to the recovery area for ~1 hour and then sent home with medication for pain control.
Expectations/Instructions
Expectations/Instructions
Pain
Adults will experience a sore throat for up to 2 weeks, while children usually recover more quickly. You will be given a liquid narcotic pain medication or a pill. Even with pain medication throat pain will still be significant. Children under 6 years of age can alternate use of ibuprofen and Tylenol® (acetaminophen) for pain control. See this
dosing chart.
Diet
Hydration is the most important concern after surgery. Encourage your child to drink plenty of liquids. We recommend avoiding chips, taco shells, and foods that have pointed edges that may cause pain or bleeding in the first week to 10 days. Use cool, soft foods such as: ice cream, yogurt, Jell-O® or pudding. Citrus products may cause discomfort. If your child does not want to eat solid foods, initially, this is OK as long as they are drinking something.
Bleeding
There is a <5% chance of bleeding after surgery. Cold ice water will help keep bleeding under control. You may expect some blood tinged saliva within the first 2 days post-operatively. If more than 2 tablespoons of bright red blood is seen within a 1 hour span, contact our office. Any brisk bleeding, recurrent/persistent oozing demands an immediate call. This may require more instructions or a trip to the emergency department. If major bleeding occurs, go the nearest emergency facility. For pediatric patients, please go to Tucson Medical Center Children's Emergency Room (TMC) for further care.
Activity
You may perform only light activities for 2 weeks – no sports or lifting over 10 lbs. Children should stay out of school for a minimum of one week due to discomfort and hydration issues. Adults may require up to two weeks from school or work.
Ear pain
This is referred pain and is related to the healing process. It is not indicative of an ear infection in the post-operative period.
Fevers
Low grade fevers are common. A fever of 101.5º F should be reported to the physician.
Neck stiffness
This is particularly common after adenoidectomy. This is due to the adenoids being right next to the muscles that allow neck movement. This should be of concern if it is associated with a temperature of 101.5º F or higher.
Bad Breath
It is common to have bad breath for a couple of weeks after tonsillectomy/adenoidectomy. This is not indicative of an infection and is normal during healing.
Follow-up
Office follow up visits are usually not necessary. Check with your physician if an appointment is needed. Please call with any questions or concerns that may arise. Our physicians will be happy to see you for any issues.
Expectations
Your ear will be plugged and congested for up to a month after the surgery. This is because there is self-dissolving material that is placed into the ear during the surgery. There is also blood and fluid from the surgery that must be cleared by the body. This takes about a month to clear up. Your hearing will also be decreased on the operated side. This will improve as the eardrum heals. It is normal to have some drainage of old blood and mucous for a week after the surgery. This will improve after ear cleaning on follow-up visits. You may have some taste disturbance after the surgery. This is usually temporary and will take a few weeks to resolve.
Dressing
The plastic cup dressing should stay on the operated ear through the first post-operative day. You can take off the dressing the morning after surgery. Try to keep this on as much as you can the first week until your post-operative visit.
Activity
Please do not blow your nose. If you need to sneeze, please sneeze with your mouth open. Please do not perform any strenuous activity or heavy lifting greater than a gallon of milk for the first week. This helps to minimize the risk of bleeding. If you have any constipation, please take an over-the-counter stool softener to minimize straining as this will also incite bleeding. Please take great care to perform dry ear precautions (see below). You may shower 2 days after the surgery. Typically, one can return to work/school about 1 week after the surgery.
Dry ear precautions
When showering or bathing, it is important to rub some Vaseline® on a cotton ball and use this to block the hole of the ear canal on the operated side. This will help seal out water from the ear canal. Water increases the chance of infection and decrease success of the surgery.
Pain
Generally, this is a well tolerated procedure with minimal pain. Please take the prescribed pain medications as needed.
Antibiotics
You may be prescribed oral antibiotics and/or ear drops. Please use these as instructed.
Diet
You can eat a normal diet. You may have some nausea after the procedure. However, this will usually pass within 24 hours of the surgery.
Precautions
There are a few things you should look for after the surgery. If you have significant, brisk bleeding of bright, red blood, then you should call the office or the physician on call. If you have severe dizziness or nausea/vomiting, please call the office or the physician on call or go to the nearest emergency room. If there is any weakness or paralysis of the face, then please call the office or the physician on call immediately.
Follow up
You should have a follow-up visit around 1-2 week(s) after the surgery. The ear canal is debrided at that visit. If you do not already have an appointment, please call the office and schedule an. If you have any questions or concerns, please do not hesitant to contact us.
What to expect
Crusting and congestion up to 4 weeks. Treatment area will be tender for 3-5 days. Mild swelling and inflammation.
- Do not pinch or manipulate treatment area.
- Use nasal saline spray, 2 sprays in each nostril as needed. This spray can be used at any time to help moisturize your nose. Try to use it at least 4 times a day for a few days for improved healing.
- Use the mupirocin ointment in the morning and at night after the above routine. Apply a small amount to a Q-tip and apply just inside nostril, moving in a circular motion.
- If you need to sneeze, sneeze with your mouth open.
- If you need to blow your nose, do so gently until your follow-up.
- If you have a nosebleed, saturate a cotton ball with Afrin® and then place it snugly in the bleeding nostril. Leave it in place for 30 minutes and then gently remove it.
- If you have any difficulty breathing through your nose, you can use Afrin, 1 spray in each nostril for a total of 3 days.
- For the first 3-4 days after the procedure, you may use Tylenol® (acetaminophen) or ibuprofen every 4-6 hours for pain while awake.
