After surgery, hearing may be better immediately on awakening, but a small amount of bleeding behind the ear drum can keep hearing somewhat decreased. After ten days to two weeks, the fluid behind the ear drum will dry, and the improvement in hearing becomes dramatic. The new hearing is generally quite sensitive, so louder noises should be avoided until the ear retrains itself to hear sounds properly.
The first weeks after surgery, lifting heavy objects, blowing the nose strongly, or allowing water in the ear must be avoided. After surgery, it is advisable to stay at home for about a week. In some occupations requiring heavy physical work, three weeks of rest at home is appropriate to allow complete healing and return of hearing. Noises in the ear (tinnitus) after surgery are unpredictable, but about half the patients that have tinnitus before surgery have significant relief within six weeks of the operation.
Dizziness or an off-balance feeling can be noted after surgery, but these disappear within 10 days. Severe types of dizziness or vertigo could be signs of an incomplete seal between the fluids of the middle and inner ear. This condition calls for immediate bed rest, recheck by the ear surgeon, and in rare instances, a need to reopen the ear drum to check the fit of the prosthesis.
Mild pain or pressure is common the first few days after surgery, but is usually gone by the end of the first week. Medication such as Tylenol or Tylenol with a minimal amount of codeine can help with comfort in those first few days.
Water in the ear must be avoided. Its entering the ear canal can moisten the cut in the skin and cause infection, or in the worst case scenario, water could enter the middle ear and cause an infection within the inner ear which could lead to complete hearing loss.
Thus, strict water precautions are very important. The ear canal should be carefully protected with cotton ball soaked in vaseline, or a lambs wool ball if the hair is to be washed. The surgeon will generally give specific instructions on when and how this is allowed.
The return to normal or near normal hearing can be expected in more than 90 percent of cases. Three or four percent will improve, but not to full normal levels. Three or four percent could remain unimproved.
Abnormal development of the bones of the middle ear can be noted in one case out of one hundred. In these cases, the surgeon may decide that the risk of proceeding with the surgery is too great. The risk or total hearing loss has been lowered to 1/3 of one percent. Today’s use of the laser further reduces this risk.