Doctors for Ear Surgery Treatment

Ear surgery is a very broad term that refers to a variety of procedures that are performed for cosmetic or reconstructive purposes. There are numerous types of ear surgeries, and each of them addresses a specific concern that may be experienced by the patient.

Cosmetic ear surgery involves changing or modifying the shape and structure of the ear to improve its appearance. Unlike this, reconstructive, medical, or functional ear surgery involves making changes to the internal structures of the ear to treat a congenital deformity or injury that may impair the hearing and balance of the patient.

Most people are only aware of hearing loss, but they are not fully aware of the various conditions that can lead to hearing loss or exacerbate the existing problems. Some common ear problems that are faced by children and adults alike and can be addressed successfully with specific types of ear surgery are mentioned below:

• Infection in the middle ear (between the eardrum and the cochlea)
• Otosclerosis (abnormal bone growth in the ear)
• Hole in the eardrum (tympanic membrane)
• An ear infection that has spread to the mastoid air cells
• Pressure issues on the tympanic membrane

When these problems are mild, they can be addressed with non-surgical options. However, as the condition worsens, ear surgery becomes a necessity.

Over the years, ear surgery techniques have advanced, and microsurgical tools have made it easier to repair internal and external ear structures precisely. Some common types of ear surgeries are given below:

• Otoplasty : Commonly known as cosmetic ear surgery, otoplasty is a type of ear surgery that is performed to modify or change the shape, size, and position of the ear. People wish to get otoplasty if/when they are bothered by misshapen ears due to a congenital deformity or have an injury to the outer ear. The procedure involves making the necessary corrections through tiny incisions in the back of the ear or inside the ears. The excess cartilage and skin are removed carefully and folded with stitches to provide the desired shape and size.
• Lobuloplasty : Commonly called earlobe repair surgery, this ear surgery is performed to repair torn or stretched earlobes. The surgery involves stitching up the torn parts of the skin tissues only, as there is no cartilage present in the earlobe. Typically, dissolvable sutures are used to repair the damage, which also provides cosmetic benefits to the patient.
• Tympanoplasty: This ear surgery is performed to fix perforations or holes and restore the hearing function of the eardrum or tympanic membrane. It is a major surgery that can be performed using microsurgical equipment to minimize the trauma to the internal ear structures. Tympanoplasty involves reconstructing the eardrum using the help of a graft to resolve hearing issues.
• Mastoidectomy : This ear surgery is performed to remove diseased cells from the mastoid bone. This surgery is indicated for treating severe ear infections (otitis media), cholesteatoma, etc. It is also performed through a minimally invasive technique, and the incision is placed behind the ear to easily access the mastoid bone.
• Cochlear Implant Surgery: This ear surgery is performed to improve hearing function with the help of specialized electronic devices called cochlear implants. They don’t restore the hearing function but improve the patient’s ability to hear, understand, and comprehend speech. It involves making a small incision behind the ear, creating an opening in the mastoid bone that is connected to the cochlea, and placing the electrodes and internal device. The internal device is later connected with the outer piece of the cochlear implant to aid in hearing.
• Stapedectomy: This type of ear surgery is performed to treat otosclerosis-induced hearing loss. It restores the patient’s hearing by removing the damaged stape bone with an artificial device that functions as a sound wave transmitter.
• Ear Canal Surgery : Also known as canalplasty, ear canal surgery is performed to widen the ear canal from the outside. It is typically performed to prevent infections and smoothen out irregularities to make it easier for the doctor to access the eardrum. It is often performed with tympanoplasty or mastoidectomy.
• Myringotomy : This type of ear surgery is performed to treat otitis media with effusion. The surgery involves creating a tiny incision in the eardrum to allow fluid drainage from the middle ear. Many people confuse myringotomy with tympanoplasty, as both of them are performed on the eardrum. However, both procedures are quite different from each other.

Besides these, there are other types of ear surgeries that are performed to address various medical concerns. To learn more about these procedures, it’ll be best to talk to the healthcare provider.

As ears are very sensitive, a thorough examination of the external and internal structures is done. Along with this, depending on the type of ear surgery the patient needs, a variety of diagnostic tests and evaluations may also be done prior to the surgery. These tests help to identify the severity of the problem, if any, and also help to create a clear and concise treatment plan according to the patient’s requirements.

The standard tests include the following:

• Physical Exam: A physical exam involves checking the ear’s shape, size, and symmetry. This is usually done for cosmetic procedures, such as earlobe repair
• Hearing Test: This test measures whether the patient’s hearing abilities are compromised. It also detects the extent of hearing loss.
• Imaging Test: It can include an X-ray test, CT scan, and/or an MRI scan. These tests provide clear images of the internal structures to detect abnormalities or damage and identify the safest path to correct the defect and repair the damage.
• Ear Endoscopy: In this test, a thin tube (endoscope) is inserted into the ear canal to identify any blockages or presence of infection in the middle ear.
• Tympanometry: This test is performed when the doctor suspects eardrum damage. It measures or assesses the eardrum movements. It involves creating air pressure variations to detect whether the middle ear is working properly.
• Vestibular Exam: If the patient is experiencing balance issues, vestibular function testing is done to evaluate the hearing function and check whether the inner ear (vestibular system) is working.
• Speech and Language Assessment: This test is usually done as a trial to assess the use of hearing aids in patients who have cochlear damage.
• Routine Tests: Along with the specialized hearing evaluations, some routine tests are also performed, which include blood tests, liver function tests, urinalysis, allergy tests, etc.

Not all of these tests may be recommended before ear surgery. The selection of diagnostic tests and evaluations is made based on the patient’s medical condition. Testing is crucial to carefully evaluate the ear's health and guide the surgical approach according to the patient’s needs while reducing the risk of complications during and after surgery.

The specific instructions that patients must follow before surgery depending on the type of ear surgery he/she is undergoing. Some general preparation tips will include the following:

• Talk to the insurance provider to clearly understand coverage policies for the treatment or surgery planned for you. Coordinate with the hospital or healthcare provider to understand the insurance claim process.
• Get all the pre-operative diagnostic tests done and submit the reports to the doctor’s team. Also, keep them in hand during your visit to the hospital.
• If you take some medications, such as aspirin, blood thinners, etc., or herbal supplements, the doctor may advise you to stop taking them or adjust their dosages in the weeks leading to the surgery.
• Arrange for transportation or commute after the surgery, as you won’t be able to drive or perform any other activity that requires concentration.
• Regardless of the type of ear surgery recommended for you, the doctor will advise you to fast for a specified period of time before the surgery and keep an empty stomach to reduce the risk of anesthesia-related complications.
• If you have a habit of smoking or drinking, the doctor may advise you to abstain from these habits or quit entirely for a specified period before and after the surgery.

If there are any other specific instructions that you need to follow beforehand, the doctor and his/her team will coordinate with you accordingly.

Both cosmetic and functional ear surgery provide numerous benefits to patients, adults, and children. The key advantages of each type of ear surgery are listed below.

• Otoplasty corrects protrusion and asymmetry in the ears to improve overall appearance. It also creates a balanced and harmonious facial profile, which further improves the patient’s self-esteem and boosts confidence.
• Earlobe repair surgery restores the natural shape and size of the earlobes and allows patients to wear earrings and other accessories again.
• Reconstructive ear surgery successfully addresses hearing problems that are caused due to congenital deformities, trauma, injuries, etc.
• Tympanoplasty repairs the holes and/or perforations in the eardrum and can restore and significantly improve hearing abilities.
• Mastoidectomy benefits the patient by treating chronic ear infections and providing long-lasting relief from pain and swelling.
• Stapedectomy restores the hearing loss caused due to otosclerosis and enables the patient to receive sound transmissions again.
• Cochlear implant surgery benefits patients by allowing them to partially hear again with the help of a prosthetic device and improve their communication abilities.
• Myringotomy allows proper fluid drainage that improves hearing and resolves balance issues that are often caused due to pressure fluctuations in the eustachian tubes.

Generally, ear surgeries aim to restore and improve the form and function of the ears. The specific benefits of each surgery depend on the nature of the surgery and the reason for which it is being performed.

Whether you are undergoing cosmetic or functional ear surgery, there are several risks and complications associated with the procedure. They include the following:

• Dizziness and imbalance, which may be temporary or persist for a long time.
• Hearing loss may persist or even get worse after the surgery.
• Frequent headaches and fatigue, which usually resolve once the ear heals.
• Pain around the surgical site, which may persist longer than 2 weeks.
• Tinnitus or head noise, which includes clicking, popping, pulsing, or ringing sounds in the ear.
• Infection in the incision site due to poor hygiene.
• Bleeding from the ear or through the incisions.
• Facial nerve damage or facial palsy.

Besides these, some patients may also experience vertigo, dizziness, muscle weakness, balance problems, changes in taste, or allergic reactions to the anesthesia, tape, suture material, glues, blood plasma, or other medications. Besides these, in some cases, the patient may also have abnormal scarring, or the problem may not be resolved completely, which will necessitate another surgery.

After surgery, ears become oversensitive and require extensive care and precautions for a smooth and successful recovery. Depending on the type of ear surgery performed, the recovery can take anywhere around 3 to 6 weeks or even more. Throughout this period, the patient has to be very careful and adhere to all the guidelines given by the doctor. If the surgery is performed on a child, his/her parents must be extra careful in complying with the care instructions.

Some common instructions include the following:

• Change the dressings and bandages that are wrapped around the stitches frequently to keep the ear dry and prevent moisture buildup that can lead to infection.
• Do your best to prevent water from entering the ear canal. If you are washing your own face or the child’s face, use a cotton ball covered with antibiotic ointment or Vaseline to cover the outer ear.
• There may be a thick, bloody drainage from the ear in the following days after surgery, which should be cleaned properly as advised by the surgeon.
• Don’t try to remove the dressing placed over the stitches unless advised otherwise.
• Take all the prescribed medications, including painkillers, antibiotics, etc., to manage the pain and reduce the risk of infection.
• Avoid any or all activities that can affect ear function, including sports activities or even listening to loud music.
• Do not skip or delay the follow-up consultations. The doctor will monitor your progress, ensure that the ear is healing well, and adjust your medications accordingly.

From wound care to avoiding activities during the recovery, it is critical for every patient to be extremely careful in their day-to-day life.