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What causes ear infection after a tympanomastoidectomy operation?

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Posted on Tue, 15 Apr 2014
Question: my brother have undergone tympanomastoidectomy operation five and half months back. two three weeks back we can say some white granulation appeared on tympanic menbrane, some yellow colored liquid is also oozing out from ear evry morning when he is getting up from bed. Doctor says its a severe allergy, scraped that area. But white granulation can be seen from outside right on the eardrum, if we slightly pull the ear backside. Please say what is it .
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Answered by Dr. Satvinder Bakshi (10 minutes later)
Brief Answer: Please meet your ent doctor Detailed Answer: Hello Please dont worry as it is common for an infection to develop after a tympanomastoidectomy surgery and this can be due to various reasons like water entry or during an episode of cold. The granulations can be due to the infection or second possibility maybe due to allergy , although it is very rare ! The white coloured mass you are seeing maybe the granulations or pieces of gelfoam which are placed in the ear after surgery. The other possibilities are a fungal infection causing a white fluffy mass in the ear or it can also be wax. It is difficult to say without examining your brother. Please dont worry and meet your ent doctor , he will examine and guide you further. Please follow his advice!! Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Satvinder Bakshi (24 hours later)
Hello Dr. Bakshi, First of all thanks a lot for your answere. Today my brother have revisit the doctor again, he again have scraped the bone, saying he is cleaning the debris. Additional info is this he said the skin formation is not happening on bone. Please tell us doctor why it is so? what could be the reason. He have given only one drop and one SOS ointment for itching.
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Answered by Dr. Satvinder Bakshi (1 hour later)
Brief Answer: Please have patience!! Detailed Answer: Thanks!! Well, this is pretty normal and it takes upto 6 months for the skin to form again!! In the surgery the diseased mucosa and bone are removed therby exposing the bone and reducing the blood supply to the area above it. Skin needs some blood supply to survive and since the bone has been scraped and bared, the skin will not survive on the bone directly , hence it takes time for the bone to be covered! As the healing process occurs , the bone will grow its blood supply again and the skin will start lining it! This is a slow process and can take upto 6 months. Please meet your doctor frequently ( once in 2 weeks ) for cleaning the debris and assessing the healing status! Thanks
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Satvinder Bakshi (22 hours later)
Dear Sir, Many thanks for your clarification. If you can please answere some of my queries. Sir where from this debris are generated? How a patient can assess the healing status? My brother always feel there is one point of problemetic area inside his ear, where from all these additional difficulties are generating. Now whether the problem is inside the middle ear or in outer ear, very close to middle ear, not able to say definitely. Sir after doing mastoidectomy is there any chance of problem inside the inner ear? Without touching the tympanic membrane can doctor scrape the ossicles? Will be extreamly thankfull to get all your highly explanatory answeres. Regards,
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Answered by Dr. Satvinder Bakshi (5 hours later)
Brief Answer: debris is natural!!. Detailed Answer: Hello!! Well I can understand your concern but I would like to assure you that your brother will be fine! Debris is natural in the ear and consists of dead cells, dirt and ear wax. It is produced in the external ear. It is highly unlikely that there will be a single point for this production and it cannot be localised as it is produced from whole of the external ear. The cleaning mechanism of the ear is hampered after surgery and therefore he will need to get it cleaned by the doctor for at least six months It is not possible to scrape the ear ossicles without removing the ear drum!! Please dont worry!! He will be fine! Thanks
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Satvinder Bakshi (10 days later)
Hello Dr., Hope you are doing extremly fine. By now i got all my questions answered by you with clear explanations. I have some more queries related to brother's ear, please guide us Sir. As you know earlier his ear was oozing liquid clear water like and sometimes clear pale yellow like. --- No liquid is now oozing from his ear. As prescribed by doctor, he is giving steroid ear drop dexamethasone thrice in a day. I told you before that chalky white sedimentation I can see inside his ear probably right on his ear drum. Doctor who have operated him said it may be due to some severe allergical outcome. I also informed you that on 10th march he scraped inside the ear leaving the eardrum area, he scraped the bone as well by saying to get skin formation perfectly. ------- I came to know from internet that chalky white sedimentation may be due to tympanosclerosis. What is it doctor? Is it worrysome? As such my brother is not facing any itching and oozing out problem now because of said allergical issues. His botherations are 1. He is feeling numbness, heaviness on the side of operated ear-- not continous but occasonally, mostly back of the ear. 2. Sometimes he is feeling pain on the backside of the ear and back of the mastoid bone --- not very heavy pain but tolerable pain. 3. He is still worrying that in his middle ear mastoid hole area is quite big now, why at all the healing is taking too much of time fo lining the bone. It's now 5+ months going on. Is everything what he is facing normal or should we do something more for better clarification? Waiting for your valuable feedback. With kind regards,
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Answered by Dr. Satvinder Bakshi (56 minutes later)
Brief Answer: Please dont worry!! Detailed Answer: Hello well, i am very happy that your brother is doing well and there is no more oozing!! Please continue the prescribed drops! It is highly unlikely that your brother is having tympanosclerosis as this is generally not seen from outside and even if he is having , there is nothing to worry and it will resolve in few months. Tympanosclerosis is basically a healing process of the ear , which has become excessive !! and generally this does not cause any symptoms or trouble! The hole will generally remain big , as it is better for proper drainage and healing of the ear , so you XXXXXXX have to worry about it! The healing generally takes 6 months to a year and is very slow , so you have to be patient and till then ,your brother will have to meet his ent doctor regularly for cleaning the ear. The numbness behind the ear is due to the surgery and may not recover completely, but your brother will get used to it in a few months and will not notice it. The pain maybe due to a mild infection slow re innervation of the ear and will subside in a few more weeks as the infection subsides. I would also recommend that your brother keep the ear dry and not let water enter it. Take care!! Thanks
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Satvinder Bakshi

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Practicing since :2007

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What causes ear infection after a tympanomastoidectomy operation?

Brief Answer: Please meet your ent doctor Detailed Answer: Hello Please dont worry as it is common for an infection to develop after a tympanomastoidectomy surgery and this can be due to various reasons like water entry or during an episode of cold. The granulations can be due to the infection or second possibility maybe due to allergy , although it is very rare ! The white coloured mass you are seeing maybe the granulations or pieces of gelfoam which are placed in the ear after surgery. The other possibilities are a fungal infection causing a white fluffy mass in the ear or it can also be wax. It is difficult to say without examining your brother. Please dont worry and meet your ent doctor , he will examine and guide you further. Please follow his advice!! Thanks