Ear Surgery: Preparation, Recovery, Long-Term Care - Verywell Health

Ear surgery can serve cosmetic or functional purposes. Some people choose to change the shape of their ears while others require surgery to prevent chronic ear infections or improve their hearing. Here's what you should know before having an operation on your ears.

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What Is Ear Surgery?

There are various types of ear surgery, ranging from plastic surgery that pins the ears closer to the head to complex surgical procedures that tackle the tiny structures within the ear canal.

Plastic surgery techniques usually involve basic incisions and suturing. To address the more complicated systems inside the ear, surgeons may use an endoscope or a surgical microscope.

Contraindications

Children often have ear surgery. It's generally best to wait until kids are old enough to follow directions before scheduling them for ear surgery since you'll need them to cooperate before and after the procedure. Children under age 5 should wait on cosmetic ear pinning until their cartilage has developed and can hold up after the operation.

Individuals with frequent ear infections aren't good candidates for cosmetic ear surgery. It's best to treat the cause of ear infections first to prevent future complications with additional ear procedures.

Smokers are considered poor candidates for any type of surgery since cigarettes impair the body's natural healing process. If you need ear surgery, talk to your doctor about strategies to help you quit smoking before surgery.

Potential Risks

Even with a specialized surgeon, ear surgery is not without risk. Complications may include:

• Dizziness and imbalances: Many patients feel off-balance after ear surgery, but this side effect is usually temporary. However, about 30% of patients experience balance issues that persist for an extended time.
• Facial paralysis: Your doctor will review this risk with you if it applies to your specific procedure (depending on the areas being operated on).
• Persistent hearing loss or tinnitus: Although inner ear surgery is often meant to cure these issues, in rare cases, hearing ability or "head noise" can get worse after surgery and continue long-term.

Talk to your surgeon during your preoperative consult to review the risks associated with your specific procedure. A qualified surgeon will only schedule you for ear surgery if the potential benefits outweigh the risks.

Purpose of Ear Surgery

Various diagnoses can lead to ear surgery. People may opt for cosmetic ear surgery to pin back ears that stick out, change their earlobe shape, correct superficial ear deformities, improve symmetry, or reconstruct tissue lost from trauma.

Ear tube surgery (typically performed on children) inserts a small plastic tube in the eardrum to facilitate airflow and assist with fluid drainage for kids with chronic ear infections. Adults can also have ear tube surgery (called a myringotomy), but it's less common.

Many internal ear conditions can be corrected via endoscopic procedures. Instead of making an incision behind the ear, the surgeon gains access to the middle ear through the ear canal. Endoscopic ear surgery can treat issues such as:

• Acoustic neuroma: Noncancerous growth on the nerve that connects the inner ear and the brain that can impact hearing and balance
• Cerebrospinal fluid leaks: A hole in the membrane surrounding the brain resulting from congenital malformation, trauma, tumors, infections, or surgery
• Cholesteatoma or cholesteatoma granuloma: A benign cyst that's located within or near the middle ear
• Facial nerve disorders: An abnormal cluster of blood vessels that can cause facial paralysis or twitching
• Ossicular chain discontinuity or fixation: The malformation, fusion, or absence of tiny bones responsible for the transmission of vibrations for hearing
• Osteoma: A slow-growing, non-cancerous growth in the bones around the ear canal caused by repeated cold-water exposure
• Otosclerosis: A genetic disease that blocks sound transmission due to a fixed stapes bone
• Paraganglioma: A rare glomus tumor on the temporal bone or middle ear that causes patients to hear a "heartbeat" in their ear
• Ruptured eardrum: Tympanic membrane perforation from trauma, loud sounds, air pressure changes, or infection
• Temporal bone encephalocele: An opening at the sides or base of the skull, allowing brain tissue to protrude
• Tympanosclerosis: New bone formation, scar tissue, or calcium deposits caused by chronic ear infections

Individuals with hearing loss may have surgery to get a cochlear implant or another type of implanted device to assist with hearing.

If you believe that you or your child is having a medical emergency, call the doctor or 911 right away.

How to Prepare

Here are some things to keep in mind as you get ready for an ear operation.

Location

Ear surgery may occur in the hospital, at a surgeon's office, or in an outpatient clinic. If you're unfamiliar with the surgery location, plan ahead to make it to your appointment on time.

What to Wear

Surgery on the ear can lead to some bleeding or fluid leakage. Wear comfortable clothes that are easy to remove without having to pull them over your head. Choose a top with zippers or buttons that's easy to wash and change in and out of.

Food and Drink

Restrictions on food and beverages before surgery will depend on the type of anesthesia being used. If you're getting general anesthesia for the operation, you'll need to fast for a period of time before surgery to ensure that there's no remaining food in your stomach.

Local anesthetics don't require changes to your intake beforehand, but you should ask the surgeon about eating after the procedure. If your jaw will be sore, you may want to purchase soft foods or liquid meals to have on hand when you get home.

Medications

Your doctor (or child's pediatrician) will review any medications that should be discontinued before ear surgery. You may be advised to stop meds that increase bleeding. Always share all supplements and medications (both prescription and over-the-counter) with your doctor to avoid potential complications.

What to Expect on the Day of Surgery

Here's an overview of ear surgery day.

Before the Surgery

When you arrive for your appointment, a nurse will check you into the surgery room to take your vitals and answer any last-minute questions. Be sure to bring your insurance information, identification, and leave extra time to complete preoperative paperwork.

Based on the type of sedation, an anesthesiologist or your surgeon will come in to administer medication and review potential side effects. Before you know it, the procedure will be underway.

During the Surgery

Plastic surgery on the ear takes about two hours and may be performed under local anesthesia or general anesthesia. An incision is made behind the ear to expose the cartilage for folding, reshaping, and repositioning the ear closer to the head. Your surgeon may remove the skin before suturing the area.

Endoscopic ear surgery, tube placement, and other surgeries (like implants or tumor removal) involve their own process that may vary depending on the practitioner who performs the operation. A thorough consultation before ear surgery will give you a good idea of what to expect during your procedure.

After the Surgery

Once your ear surgery is complete, your doctor will ensure that proper bandages, drains, or packing material is secure for you to go home. You'll receive discharge instructions on how to care for your wounds and when to follow-up with your surgeon (typically within a week).

For less invasive surgeries, including endoscopic ear surgery, you'll be able to go home on the same as your operation. However, extensive tumor removal surgeries may require you to remain in the hospital for two to three days for monitoring before you're cleared to leave.

It's unlikely that you'll be allowed to drive after ear surgery, so a reliable friend or family member will need to bring you home and assist you around the house for at least 24 hours.

Recovery

Plan ahead to ensure you can stay home from work and minimize other responsibilities to allow sufficient time for healing. Your surgeon will advise you on the length of time needed for a full recovery, depending on your health, age, and type of operation.

Ear tube surgery usually only requires one day of rest before children can return to eating normal foods and participating in activities. Surgery on the inner ear can take about eight weeks to heal fully, but most people can return to work within a week to ten days.

Your doctor will schedule a time to check your hearing, usually two to three months after surgery.

Healing

Common symptoms after ear surgery may include:

• Drainage: Your surgeon may place a drainage tube behind your ear to reduce swelling after surgery. This will be taken out during your post-operative visit.
• Dry mouth: Your ears are linked with your nose and throat, so surgery on the ear may cause side effects in the mouth, like dryness.
• Numbness: Surgery can cause you to lose feeling in the skin around and inside your ear for six months or more.
• Pressure or popping: If your surgeon placed packing material in your ear after surgery, it can impact your natural equilibrium and cause ear pressure. This effect should go away when your doctor removes the packing.
• Stiff or sore jaw: The jaw begins at the front of the ear canal, so ear surgery can lead to temporary jaw issues.
• Taste changes: If your surgery disrupts the nerve that runs through your middle ear, some taste sensations may be affected.
• Tinnitus: A "ringing in the ears" is common when dulled hearing hasn't fully returned yet.

The above symptoms should clear up as your ear heals from surgery. However, some of these symptoms can last permanently as an unintended side effect of surgery. Talk to your doctor about what to expect during recovery and how persistent symptoms may be addressed with future treatments if needed.

Coping With Recovery

Avoid blowing your nose too hard or eating hard or chewy foods in the early days after ear surgery. You'll need to take extra care to keep your incision sites dry and clean until they get a chance to heal fully. Avoid swimming, hot tubs, or baths until your surgeon says it's OK.

For pain after surgery, you'll be provided with guidance on using ear drops and medication. You may need to take antibiotics or use antibiotic ear drops to prevent infections.

It can be frustrating to cope with the above symptoms (like jaw stiffness or ringing in the ears) but give yourself time to recover with the understanding that any negative side effects should be temporary.

Long Term Care

After everything goes well with your ear surgery and healing, it's easy to put your health on the back-burner. However, make an effort to keep up with your doctor's recommended follow-up schedule to monitor your hearing and any other symptoms going forward.

Follow general ear care recommendations, like avoiding sharp objects in your ears and loud music in headphones. Maintaining a relationship with your primary care doctor by attending your scheduled preventative care appointments will give you a point person to check with if issues arise in the future.

Possible Future Surgeries

With any form of cosmetic surgery, there's always the chance you'll need a revision. Sometimes the healing process leads to unexpected results, and adjustments are necessary to reach your desired final look. If ear pinning surgery creates an asymmetrical result, your doctor may recommend small fixes with additional surgery.

Ear tubes usually fall out on their own when children outgrow them. If the eardrum doesn't fully close after this happens, surgery may be required to repair the eardrum.

Patients who receive cochlear implants or other hearing assistance devices should meet with an audiologist for rehabilitation therapy to help them adjust and make use of the device. It takes time to learn a new system of communication, so getting the implant placed is just the beginning.

Ask your audiologist about your surgery, along with the recommendations for follow-up care to understand the scope of what's required after your procedure.

A Word From Verywell

Ear surgery can be a life-changing experience. If your surgical recovery includes some setbacks, it's OK to reach out for support. Connecting with others who have struggled with hearing loss or similar issues can help you feel like you're not alone on your journey.