Patient Care

Postoperative Instructions

Precautions:

Do not blow your nose until such time as your doctor has indicated that your ear is healed. Any accumulated secretions in the nose may be drawn back into the throat and expectorated if desired. This is particularly important if you develop a cold.

Do not "pop" your ears by holding your nose and blowing air through the Eustachian tube into the ear. If necessary to sneeze, do so with your mouth open.

Do not allow water to enter the ear until advised by your doctor that the ear is healed. Until such time when showering or washing the hair, lamb's wool or cotton may be placed in the outer ear opening and covered with Vaseline. If an incision was made in the skin behind your ear, water should be kept away from this area for two weeks.

Do not take any unnecessary chance of catching cold. Avoid undue exposure or fatigue. Should you catch a cold, treat it in your usual way, reporting to us if you should develop ear symptoms. You may anticipate a certain amount of pulsation, popping, clicking, and other sounds in the ear and also a feeling of fullness. The occasional occurrence of sharp shooting pains is not unusual. At times it may feel as if there is liquid in the ear.

There are no specific travel restrictions. During the first two weeks following surgery, however, commercial air travel is preferred to automobile or train travel for trips over 200 miles. It is advisable to chew gum to stimulate swallowing when there are altitude changes while traveling.

Dizziness:

Minor degrees of dizziness may be present on head motion and need not concern you unless this should increase.

Hearing:

Rarely is hearing improvement noted immediately following surgery. It may be temporarily worse due to swelling of the ear tissues and packing in the ear canal. An improvement may be noticed 6-8 weeks after surgery. Maximum improvement may require 4-6 months.

Discharge:

A bloody or watery discharge may occur during the healing period. The outer ear cotton may be changed if necessary, but in general, the less done to the ear the better.

A yellow (infected) discharge at any time is an indication to call the appointment desk and arrange to see your doctor.

Pain:

Mild, intermittent ear pain is not unusual during the first two weeks. Pain above or in front of the ear is common when chewing. If you have persistent ear pain, not relieved by a few aspirin, call the appointment desk and arrange to see your doctor.

Eardrops:

If your doctor wishes you to use eardrops you will receive them when leaving the hospital. Begin using the eardrops 2 weeks after surgery, a few drops twice daily to loosen the ear packing, which will run out of the ear as a liquid. Tip the head to the side and place two drops in the ear, allowing them to remain for 5 minutes. Then tip the head in the opposite direction tot allow the ear drips to run out. Continue doing this twice daily until you have finished the drops or until advised otherwise by your doctor.

Brandt-Daroff Exercises for the Treatment of BPPV

Brandt-Daroff Exercises

Do NOT do this unless you have seen your doctor and he has made this suggestion

The Brandt-Daroff Exercises are a method of treating BPPV usually used when the office treatment fails. They succeed in 95% of cases but are more arduous. These exercises are preformed in three sets per day for two weeks. In each set, one performs the maneuver below five times.

1 rep = maneuver done to each side in turn

Suggested Schedule

Morning

5 reps

10 minutes

Noon

5 reps

10 minutes

Evening

5 reps

10 minutes

One starts upright, then one moves into the side-lying position, with the head angled upward about half way. An easy way to remember this is to imagine someone standing in front of you, and just keep looking at their head at all times. Stay in the side-lying position for 30 seconds, or until the dizziness subsides if this is longer, than go back to the sitting position stay there for 30 seconds, and then go to the opposite side in the same way.

If during a session, the exercise fails to produce symptoms, stop the exercises for that day. If no symptoms can be produced during the first session or the next, then stop the exercises entirely. In most persons, complete relief from symptoms is obtained by one week. For a virtual image of what the exercises are supposed to look like click here and you will be connected to a site produced by Northwestern University .

Vestibular Exercise Program to Overcome Dizziness

Do NOT do this unless you have seen your doctor and he has made this suggestion

VESTIBULAR EXERCISE PROGRAM TO OVERCOME DIZZINESS

AIMS OF EXERCISE:

1. To loosen up the muscles of the neck and shoulders, to overcome the protective muscular spasm and tendency to move "in one piece."

2. To train movement of the eyes, independent of the head.

3. To practice balancing in everyday situations with special attention to develop the use of the eyes and the muscle senses.

4. To practice head movements that cause dizziness, and thus gradually overcome the disability.

5. To become accustomed to moving about naturally in daylight and in the dark.

6. To encourage the restoration of self-confidence and easy spontaneous movement.

All exercises are started in exaggerated slow time and gradually progress to more rapid time. The rate of progression from the bed to sitting and then to standing exercises depends upon the dizziness in each individual case. Perform these exercises twice daily.

A. SITTING POSITION - without arm rests.

1.Eye exercises - at first slow, then quick, 20 times.

a. Up and down.

b. Side to side.

c. Repeat a and b, focusing on finger at arm's length .

2. Head exercises - head movements at first slow, then quick, 10 times.

3. Shrug shoulders and rotate, 20 times.

4. Bend forward and pick up objects from the ground, 20 times.

5. Rotate head and shoulders slowly, then fast, 20 times.

6. Rotate head, shoulders and trunk with eyes open, then closed, 20 times.

B. STANDING:

7. Repeat number 1.

8. Repeat number 2.

9. Repeat number 3.

10. Change from a sitting to standing position, with eyes open, then closed.

11. Throw ball from hand to hand (above eye level).

12. Throw ball from hand to hand under knees.

13. Change from sitting to standing and turn around in between.

14. Repeat number 6.

C. WALKING

15. Walk across room with eyes open, then closed, 10 times.

16. Walk up and down slope with eyes open, then closed, 10 times

17. Do any games involving stooping, or stretching and aiming, such as bowling, shuffleboard, etc.

18. Stand on one foot with eyes open, then closed.

19. Walk with one foot in front of the other with eyes open, then closed.