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POST-OP INSTRUCTIONS: Tympanostomy tube insertion

1. Water must not enter the ear canal as it will pick up bacteria from the canal and carry them through the tube into the middle ear space, possibly causing a middle ear infection. This may be accomplished by avoiding head submersion or by using molded ear plugs in conjunction with bathing caps or brightly colored sweat bands. You may arrange to have custom-molded ear plugs called "swim molds" made for your child. Ask my staff about these. For temporary water precautions, a piece of soft cotton coated with Vaseline™ should be placed in the entrance to the ear canal to make it water tight.

2. REMEMBER TO AVOID THE USE OF ADVIL™, MOTRIN™ FOR THE FIRST TWO WEEKS FOLLOWING SURGERY. Like aspirin, they may cause postoperative bleeding and plug the tubes. Pain or headaches should be treated with an over the counter medication such as Tylenol™ at the dosage recommended on your child's discharge orders.

3. If water accidentally enters the ear canal because your child's head is underwater and the swim mold falls out, use one dose of the ear drops, 3 drops, in the affected ear or ears.

4. Be prepared for some drainage of fluid from your child's ears for the first days after surgery. Ear drops have been placed in the child's ears at the time of surgery and these may continue to drain. A small cotton or gauze wick may have been placed in your child's ears. These wicks only absorb excess ear drops and may be removed any time following surgery.

5. Occasionally there will be blood-tinged fluid draining from the ear. If this persists during the day of surgery or the blood-tinged fluid becomes more bloody, please notify me.

6. I will ask you to place eardrops in your child's ears for at least three days after surgery. Usually three drops should be placed in each ear three times a day. Don't throw the bottle of drops away after this three day period. They may be used on a one-dose basis should water accidentally enter your child's ear. The ear drops have a one year shelf life.

7. Your child should visit me two to three weeks after surgery to check tube function and to arrange a post-operative hearing test.

8. While your child has a tube in an eardrum, it is important to keep all follow-up appointments. Follow-up evaluation includes examination of the ear canals to ascertain the positions of the tubes. When the tubes fall out of the eardrums, it is necessary to be certain that the drum is healing normally. Even if you notice that the tubes have fallen out of your child's ears onto the pillow, water precautions should be maintained until your child has been checked to make certain that the eardrum hole no longer exists before resuming water-related activities unprotected.

9. Be on the lookout for drainage from your child's ears, particularly during "colds" or serious teething. If you notice drainage, begin the ear drops 3 drops 3 times a day and call me. I will prescribe an antibiotic by mouth and arrange to see your child for followup.

10. Communications are important! If you have questions or concerns, I am available at all times to discuss these with you. Please call and leave a message at my office.

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