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Ear pain after tympanoplasty operation. Brain CT scan showed mastoiditis. What to do?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2559 Questions

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Posted on Fri, 25 Jan 2013 in Ear, Nose and Throat Problems
Question: I had tympanoplasty operation at right ear on 23rd nov, 2012,
hearing improvement is being in process slowly.
But i am feeling pain at right side slightly behind ear and neck
Then according to doctor i have done CT scan brain(plain).
It is showing right sided MASTOIDITIS.
Please suggest what should I have to do.
doctor
Answered by Dr. Sumit Bhatti 25 hours later
Hi,

Thank you for your query.

1. If you can share the CT Scan images, it will help in understanding the changes due to the operation and the severity of the mastoiditis.

2. Do you have any pre-operative examination notes and the operative notes? If so, please upload them too.

3. Usually the ear and mastoid should heal in 4-6 weeks, though XXXXXXX healing may take longer. Gelfoam normally placed in the middle ear and packed in the outer ear canal may take many weeks to dissolve and hence hearing improvement is seen slowly.

4. Please share your pre and post operative audiograms.

5. I would recommend an initial medical line of therapy including antibiotics, anti-inflammatory, anti-allergic decongestants and mucolytics.

6. The pain in your right ear is a sign of some underlying infection or inflammation and must not be ignored.

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

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 1 hour later
Sir,
Thank you for your reply and suggestion.
I am trying to share my all medical report within 2 to 3 days so that you can understand my anxiety clearly and have your further suggestion.
Once again thank you and I am looking forward to follow your advice.
doctor
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back.

Kindly share as many images of the CT Scan (not only the report) and add your ear examination reports, any endoscopic ear drum images, operative notes, discharge card, audiograms, x-rays (if any) and blood investigation reports.

Awaiting your reply,

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 22 hours later
sir,
I am attaching my pre-operation and post-operation reports and all other documents except brain x-ray images (some difficulties to be scanned).
Please go through it and give your suggestion.
One thing more, I am taking FLUNER 5 medicine for right sided pain prescribed by the doctor-ENT. This is for your kind information.
doctor
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for your query.

1. If you can get the CT Scan images on a CD / DVD or a USB memory stick from the Scan Center, you will be able to share the images.

2. The pre-operative examination notes describe a wet central perforation. Usually the ear should be dry for at least 3 weeks before an ear operation is attempted.

3. The discharge summary does not include operative notes.

4. The post operative PTA (Pure Tone Audiogram) still shows a mild conductive hearing loss. Without a pre-operative PTA, it is difficult to give an opinion. May be the gelfoam in the middle ear has still not dissolved. This may explain the 'B' type Tympanogram, but not on the Left side. The findings of the Left ear are not mentioned.

4. The CT Scan report mentions both right mastoid sclerosis and right mastoiditis. The CT images are important here. There is no mention of the left side here, too.

5. You may take a trial of medication for a couple of weeks. If there is no improvement, get a repeat ear examination done.

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

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 4 hours later
thank you
if i need further help i will get in touch with you
doctor
Answered by Dr. Sumit Bhatti 18 hours later
Hi,

Thank you for writing back.

Wishing you a speedy recovery,

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