Cholesteatoma Ear Surgery

What is a Cholesteatoma?

The ear has three parts outer ear (ear lobe and ear canal), the middle ear ( eardrum and bones of hearing) and inner ear. Cholesteatoma is skin from ear canal migrating into the middle ear. Like the skin on head keeps shedding and can cause dandruff. Similarly, skin in the middle ear can cause cholesteatoma, which can form a gradually expanding sac and can damage structures in the middle ear to give deafness, inner ear to give permanent deafness, nerve to the face to give a facial weakness or rarely give infection of the lining of the brain to cause meningitis

Is cholesteatoma surgery or mastoidectomy done under general anaesthetic?

Cholesteatoma is a surgical problem. Unfortunately, no medications work on it. Cholesteatoma surgery is called mastoidectomy, i.e. clearing cholesteatoma infection from the mastoid bone (the hard bone behind your ear). The procedure is done under general, i.e. you will be sleeping while the procedure is done. After the surgery, it is reasonable to feel sleepy and little dizzy. So it is adviced not to drive for 48hours, this includes riding a bicycle — no active physical activity like going on a treadmill for a few days after anaesthesia and ear surgery. For the first six weeks, it is adviced not to travel on the underground tube or travel by air. It is also advised to sneeze with open mouth, as trying to stop a sneeze can increase middle ear pressure. You have to avoid water going in the ear for three months post-surgery. This can be achieved by using vaseline with a cotton ball and covering the ear with disposable waterproof ear caps.

When can my child return to school after cholesteatoma surgery?

Most of the patients can return to school after one week of cholesteatoma surgery. After returning to school, they still have to avoid swimming and physical exercise (PE) for three months.

When can I return to work after cholesteatoma surgery?

You can go back to work after one to two weeks depending on your recovery. If you can work from home, you will be able to work on the computer after 3-4 days.

What is best to eat after cholesteatoma surgery?

It is advised to start with a soft diet as you can have mild nausea and vomiting due to ear surgery and anaesthesia. Then you can build up on your diet as nausea gets better. If you are getting sick and not tolerating food, you should contact your hospital as you can become dehydrated.

How do I look after my dressing after cholesteatoma surgery?

If you had endoscopic minimally invasive ear surgery then the surgeon may have used the absorbable gel in the ear canal. You will have to use antibiotic ear drops over this gel to help absorb the dressing. It is very very important to keep the ear dry from water. Please place a dry cotton ball on the ear and keep changing it twice a day. It may get soaked in blood for a few days. If the bleeding is more than two tablespoons in a day, please contact your hospital for advice.

If you have a head bandage and are going home with it, you can gently remove the dressing after 24hours. Behind the ear, the wound is stitched with absorbable stitches and covered with advanced tissue glue. Again it is vital to keep the wound dry for two weeks.

If the wound becomes painful before your follow up visit, please contact your surgeon for advice. Slight swelling around the wound is expected, but if it is increasing in size and becomes painful, then please contact the hospital. Numbness on and around the ear is normal and should resolve after a few weeks. The hearing may be low for a few weeks due to the dressing in the ear.

When can I blow my nose after cholesteatoma surgery?

After any ear surgery, i.e. mastoid or eardrum repair, it is adviced not to blow your nose for six to eight weeks. If you feel blocked then clear your nose using saline douching or decongestant sprays.

How do you control pain after Cholesteatoma ear surgery?

You will have prescription pain relief medications to take home after your ear surgery. Please take paracetamol and ibuprofen as advice. It is advisable to start with paracetamol fist in the morning then having Ibuprofen four hours later and alternating them during the day. Please do not use more than the recommended dose. Low temperature after anaesthesia and ear surgery is normal. If you have a high temperature or temperature for more than 24hours, please contact your hospital.

When do I go for follow up visit after cholesteatoma surgery?

Follow up visit depends on packing in the ear and sutures behind your ear.

If you had an absorbable dressing in the ear, then you will be seen after four to six weeks. If you have non-absorbable dressing, then it needs to be removed in two to three weeks. Your appointment will be made before you leave the hospital.

If you have stitches to be removed, then an appointment will be made in a week to remove them.

Most surgeons will follow up patients after cholesteatoma surgery for two to three years. Some patients may need an advanced MRI scan to detect the early return of cholesteatoma at one year. Your surgeon may decide to do hearing reconstruction after nine months of primary surgery. This may involve another operation.

Mr Gaurav Kumar

Ear Nose Throat Consultant

To Book An Appointment

Book Appointment Online

Call 07494914140

Email info@entsurgeonclinic.co.uk

Disclaimer: For general information only, always seek medical advice from your treating consultant.

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