Patients who have had a mastoidectomy or canalplasty are often left with an exposed area of bone inside the ear canal. Since healing takes time, this area is vulnerable to infection and formation of granulation tissue. To assist the healing process, a minor grafting procedure is often performed approximately 10 to 30 days following the mastoidectomy procedure. This procedure is done as an outpatient procedure in the hospital. It is performed under local anesthesia on adults. Small children are put to sleep, but still go home on the same day. A very thin transparent layer of skin is removed from the inner part of the arm, and then placed over the exposed surgical area inside the ear. A special ointment and silk material are used to hold the grafted skin in place.
At a clinic appointment approximately one week after surgery, the silks in your ear are removed without any significant discomfort. It is not at all uncommon to have some drainage from the ear until the time the silks removed. After removal of the silks the ear should dry up rather quickly.
The only complication of importance is infection, which could prevent the graft from healing in place. Also, the patient has an important role in keeping the arm and ear dry to prevent complications. This minor procedure has proven essential in reaching the healing process and in preventing complications of mastoidectomy.
HOME CARE INSTRUCTIONS FOLLOWING THIERSCH GRAFT
During Thiersch grafting, a transparent piece of skin is taking from the upper arm and placed inside the ear canal over the exposed tissue. A silk material and ointment are placed over the graft to hold it in place. The silk material is removed one week following the procedure. A small, clear cellophane dressing is placed over the skin graft site. This is removed at your post-operative visit in the office.
CARE OF THE EAR
- Do not allow water or any moisture in the ear.
- Change the pad over the ear at least once a day.
- Inspect ear for drainage or an odor.
- Do not put cotton into the ear. Do not use Q-tips or even fingertips in the ear canal.
CARE OF THE DONOR SITE
- Keep the area dry.
- Do not remove the clear cellophane dressing. If blood collects under it, you may sterilize a needle with rubbing alcohol, puncture the cellophane in one area and milk out the blood collection.
- Change the gauze wrap as needed.
CALL YOUR PHYSICIAN IF:
- You develop a fever of 101 degrees or greater that does not reduce when you take Tylenol.
- Excessive pain develops. Usually there is a little ear discomfort. There may be some discomfort at the donor site for the first few days. Tylenol is usually sufficient to relieve it.
- You develop shortness of breath.
Patients should make an appointment to return to the clinic in one week, unless other arrangements are made with their physician.