Ear Center: Postoperative Instructions For Envoy Esteem™ Implants

Postoperative Envoy Esteem™ Implant - Initial Procedure

Click here to download a copy of these instructions as a pdf and to print.

1. Nausea/Vomiting: You may have nausea, vomiting, or a low-grade fever for a few days after your operation. This is not unusual. However, if the nausea and vomiting become severe or last more than one day, please call our office. Medication for the nausea may be prescribed. You may take Tylenol® every four hours for fever. If your fever should rise above 101 degrees F, please contact our office.

2. Activities: Limit your activities for one week. This includes avoiding heavy lifting (over 20 lbs), vigorous exercise, and contact sports. It is not uncommon to experience some lightheadedness or dysequilibrium for several days postoperatively.

3. Do Not Blow Your Nose: Do not blow your nose for approximately one week without opening your mouth to relieve the pressure on your ears. If it is necessary to sneeze, do so with your mouth open to decrease pressure to your ears. Do not hold your nose to avoid sneezing. This is important as you do not want to blow air into your operated ear and under the skin behind your ear.

4. Washing Hair: You may wash your hair 2 days after the operation. Please protect your ear and the incision from water. We recommend placing some plastic wrap over your ear and incision to help protect against water. It may be necessary to have someone help you during the first several washings - wash "beauty parlor style". Water should be kept out of your ear and away from your incision at all times.

5. Incision Care: Try to keep the incision clean and dry. You should clean crusts from the incision area with hydrogen peroxide and cover the area with antibacterial ointment (Bacitracin®, Polysporin®, Bactroban®, etc.) three times a day for the first 2 days. Any time you are going to clean your ear, please wash your hands thoroughly prior to starting.

6. Drainage: You can expect some blood-tinged drainage from the drain site of the operated ear during the first postoperative week. If drainage increases instead of decreases, please call our office.

7. Pain Control: Some dull postoperative ear pain is expected. Your physician may prescribe pain medicine to help relieve your discomfort. If your postoperative pain increases and your medication is not helping, please call the office before taking any other medication that we have not prescribed or recommended.

8. Glasscock Dressing: At home, you may want to wear the ear cup dressing (Glasscock Mastoid Dressing) for several nights to protect your external ear and incision while sleeping. Elevate your head (30 degrees) with several pillows for 3 nights to help reduce swelling.

9. Ear Protection: If you are in a dusty environment (i.e. at work or mowing the lawn), place a cotton ball in the ear canal to prevent debris from entering.

10.Warning Signs: If any of the following should occur, please call the office.

  • Persistent bleeding.
  • Persistent fever greater than 101 F
  • Purulent drainage (pus) from ear or incision
  • Redness with swelling around the suture line
  • Persistent pain not relieved by your prescribed pain medication.

General Considerations

11. Incision: Sometimes, with a large incision behind the ear, the incision may open and drain. If this occurs, please contact our office immediately.

12. Medications: Please fill the antibiotic and pain prescriptions promptly. Take all of the antibiotic medicine as directed until the entire supply is gone.

13. Hearing: Do not be concerned about your hearing in your operated ear at this time.  You will not be able to hear anything from your ear until your Sound Processor is turned-on. Your hearing aid will not work in your operated ear. It will be necessary for you to wear yoiur hearing aid in the unoperated ear.

14. Taste: Because a nerve for taste (chorda tympani nerve) passes through your ear, it is not unusual for your taste sensation to be altered for several weeks or months. You may experience a "tinny" or "metallic taste".  Usually, your taste will slowly return.

15. Numbness: You may experience some numbness in your outer ear, earlobe, and the incision area. This is normal. Most of the numbness will be expected to fade over a period of time. The very top of your ear will be the last portion to regain sensation.

16. Swimming: Do not swim until permitted by your surgeon. Please discuss any future swimming plans with your surgeon such as scuba diving.  Eventually, you will be able to return to swimming normally.

17. Eardrum Appearance: Your eardrum may look "pink" or "red" for up to one month postoperatively. The red coloration is due to some residual blood in the middle ear. The change in color should not be confused with infection. Careful examination of the back upper quadrant (posterior-superior quadrant) of your eardrum will reveal the glass inomer cement attaching your Driver to your third hearing bone (stapes).

18. MRI Warning: THIS IS IMPORTANT - Please remember that you should never have an MRI scan after having had an Esteem™ device implanted. This is true for as long as the Esteem™ implant electronics are implanted in your body. An MRI scan could cause current to arc between the implanted leads causing significant, irreversible injury and complete failure of the implant. It is safe to have a conventional x-ray or CT scan of any kind.

19. Bathing: Please remember to bathe with soap containing chlorhexidine on days 1, 3, and 5 postop. The purpose of this is to decrease the bacterial count on your skin and help to prevent postoperative infection. Place Bactroban® nasal cream or ointment in each nostril twice per day for one week postoperatively, if prescribed by your doctor. This helps to prevent colonization with staphylococcal bacteria that can cause the device to become infected.

19. Return Visit: It is important to return to our office for your postoperative appointment as scheduled. If for some reason, you were not given a postoperative appointment or are unsure of the day and time, please call our office at (336) 273-9932.

Please call our office at 336-273-9932 if you have any questions.

Click here to download a copy of these instructions as a pdf and to print.

Last revised November 28, 2011