Ear Center: Preoperative Surgery Instructions for the ESTEEM Implant

Preoperative Surgery Instructions for Patients Having an ESTEEM Implant

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Ibuprofen, NSAID's, and Aspirin Management
What to expect on the day of your procedure
What to expect on the day after your procedure


Ibuprofen, NSAID's, and Aspirin Management Prior to Having an ESTEEM Implant


  • Please do not take ibuprofen (Motrin®), NSAID's (non-steroidal anti-inflammatory drugs such as Aleve® or any aspirin or aspirin-containing medications for 10 DAYS prior to your ESTEEM implant operation.  Such products can promote bleeding by inhibiting platelet function.
  • It is fine to take Tylenol® (acetaminophen) or Tylenol® containing medications.

Click here for a list of medications that should not be taken for 10 days prior to your operation.



1. You should arrive at the surgical facility and check-in 1 1/2 hours before your operation is scheduled to begin.

2. You may have a blood test to check your blood counts (hemoglobin). Your temperature and other vital signs will be taken. An anesthesiologist will talk to you and listen to your heart and lungs. An electrocardiogram (ECG) may be performed. An IV infusion may be started in the holding area by a nurse or an anesthesiologist. Your surgeon will speak to you and will ask if you have any questions.

3. When your operation is about to begin, a nurse anesthetist (CRNA) will take you to the operating room.

4. In the operating room, you will been given general anesthesia through an IV. Once asleep, an endotracheal tube will be placed in your windpipe (trachea) to continue the anesthesia. Your heart rate, blood pressure, temperature, and blood oxygen levels will be monitored continuously throughout your operation. A foley catheter will be placed in your bladder and will be removed prior to you awakening in the operating room.

5. Your operation will take about 3 - 4 hours. When it is over, you will be taken to the recovery room to "wake up" from the anesthesia. You will stay in the post-anesthesia care unit about one hour and then you will be taken to your room for 23 hours of observation. You will have a white plastic ear shield (Glasscock Mastoid Dressing) on your operated ear for protection and comfort.

6. The IV will stay in your hand overnight, and you will receive several doses of postoperative IV antibiotics and steroids. Pain medication may be administered directly through your IV. A small suction drain positioned behind your ear will be removed by your surgeon the next day.

7. You will be able to drink liquids and advance your diet immediately after the operation. You may experience some throat discomfort for 24 hours due to the endotracheal tube. You may experience some slight nausea until the effects of the anesthesia wear off. Medication will be given to help with any pain or nausea if this becomes a problem. You may experience some slight urinary discomfort the first time you urinate due to the foley catheter placement.

8. You will not be able to hear anything from your operated ear due to the hearing bones being separated and the fact that your ESTEEM will be turned "Off". Your ESTEEM will not be activated for approximately 3-4 weeks in order to permit middle ear fluid to resolve and for your ear to heal properly. You may wear your hearing aid in your unoperated ear. You may hear some funny sounds in your operated ear along with some tinnitus. You will experience a sensation of ear fullness in the operated ear.

9. If you wear eye glasses, you may need to remove the temple on the side of your ear operation.



1. On the morning following your operation, your IV and suction drain will be removed, and you will be discharged home or to your hotel after being checked by your surgeon.

2. Plan to stay in Greensboro for two days prior to flying home. If you are driving home, we recommend that you have someone drive you and that you get out to the vehicle and stretch for 5-10 minutes every 2 hours.

3. It is recommended that you wear your Glasscock dressing for 2-3 nights and keep your head elevated on two pillows while sleeping. Avoid lying directly on your ESTEEM for one week.

4. You will be asked to shower or bathe on Days 1, 3, and 5 with antibacterial soap containing chlorhexidine. You may purchase antibacterial soap at the grocery or drug store. You will be asked to avoid getting your scalp incision wet for 1 week. Women may wash their hair 2 days after their procedure, beauty pallor style, and protect their scalp incision with some soft plastic wrap. Men may do the same or gently wash their scalp with a warm wash cloth while avoiding their incision.

4. Please remember to take all prescribed medications and to follow your surgeon's instructions. If you have any questions, you may always contact our office at 336-273-9932 and ask to speak to a nurse.

5. You will be given written postoperative instructions and a return visit to see your surgeon. Postoperative instructions are also available on our web site under "Surgery Instructions>Postoperative Instructions>Envoy ESTEEM Implants". Your ESTEEM "Turn-On" and "Activation" will also be scheduled.


  1. Bode LGM, Kluytmans JAJW, et al.: Preventing surgical-site infections in nasal carriers of staphylococcus aureus. N Engl J Med 2010; 362 (January 7): 9-17.

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Last revised May 23, 2010