Postoperative Care

The patient is kept in the hospital overnight for observation, and the mastoid dressing is removed prior to the patient's discharge the morning after the surgery. Because the Merocel sponge canal packs must remain moist to maintain a pressure bolster against the skin graft, the patient is given a steroid-containing antibiotic otic preparation with instructions to place five drops in the ear three times a day until follow-up in 1 week. Water is kept out of the ear. At the first postoperative clinic visit, the canal packs are removed and the ear is cleaned. If there is any granulation tissue or healing areas (usually the case), the patient is continued on eardrops until the next visit. Patients are seen weekly for the first month for cleaning and debridement. The appointments are then gradually spread out based on the status of the ear. Healing is promoted and stenosis prevented by maintaining a clean ear canal. Lifelong follow-up at 6-month to 1-year intervals is often required, as the grafted canal skin is not self-cleaning and must be gently debrided of squamous epithelium to prevent chronic infection and subsequent stenosis.

After the ear has healed well, there are no activity restrictions. Patients are allowed to swim, but they may need to use drying or antibiotic drops afterward to prevent infections.

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