What Causes Plugged Ears After Tympanoplasty Procedure?

Posted on Wed, 19 Oct 2016

Question: I had a tympanoplasty late December, 2015. I was extremely satisfied and have received a clean XXXXXXX of health from my surgeon. Within the last two months, everything is fine when I wake up in the morning, but shortly thereafter, my ear seems to plug (not like before the surgery because I could not hear with it then). I have returned to the surgeon, and he is baffled. It almost seems as if there is some kind of fluid that moves around after I get up in the morning. The muffled feeling lasts throughout the day, and my hearing, although much improved, is not like it was after the surgery. Surgeon says it is healed so well he can't tell the ear drum was ever punctured. It was quite a large puncture.

Answered by Dr. Sumit Bhatti (2 hours later)

Brief Answer:
Fresh PTA, I /A, tests.

Detailed Answer:
Hi,

Thank you for your query.

1. Get a fresh PTA (Pure Tone Audiogram) and an Impedance Audiogram (I/A or Tympanogram) done.

2. Upload the preop and latest audiograms for comparison. This will help understand the reasons for this difference in hearing.

3. By going through detailed intra-operative notes, it is possible to understand the exact surgical steps.

4. Some of the reasons for this situation besides eustachian tube dysfunction (for which you are being trreated) include adhesions in the middle ear, graft lateralisation, retraction and so on.

5. Endoscopic images of the eardrum will help. An HR (High Resolution) CT scan of the temporal bones can be done.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (14 minutes later)

Doctor, based on the theory that it could be a eustachian tube problem, do you feel I should continue the Flonase procedure to give it a longer chance to work? Thank you very much!

Answered by Dr. Sumit Bhatti (19 hours later)

Brief Answer:
Two to eight weeks, otherwise investigate.

Detailed Answer:
Hi,

Thank you for writing back.

1. The Flonase should show some improvement in two weeks.

2. If there is no response after 6 to 8 weeks, consider the above investigations.

3. Rather than treating a theory, ETD (Eustachian Tube Dysfunction) can be ascertained by these tests.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar