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What Happens After Endolymphatic Sac Decompression Surgery?

Reviewed on 1/6/2021

What happens after endolymphatic sac decompression surgery?

After endolymphatic sac decompression, the ear is covered with a Glasscock dressing and the patient takes painkillers.
After endolymphatic sac decompression, the ear is covered with a Glasscock dressing and the patient takes painkillers.

Endolymphatic sac decompression surgery is done to drain excess fluid from the inner ear. After this surgery, the operated ear is covered with a Glasscock dressing, which is a special dressing applied to keep the pressure on the site to reduce swelling. There is usually some tenderness and discomfort in the operated ear and throat (from the breathing tube inserted during surgery), which may be controlled by painkillers. Hospital admission is usually not required because the procedure may be done on an outpatient basis. The patient may receive a prescription for the following medications once they leave the hospital

  • Pain medicines
  • Antinausea medicine (not always)
  • Antibiotics for four to ten days
  • Steroid taper
  • The bandage should be removed two days after surgery

Home care for the first few days

  • Remove the cotton ball from the outermost part of the ear canal.
  • Replace the cotton ball several times daily as needed to absorb drainage, if present.
  • You may wash your hair three days after surgery.
  • The incision behind the ear is typically covered with Steri-Strips and these should be left in place. These will remain on the wound for ten to twelve days.
  • Do not blow your nose for four weeks after surgery. Sniffing is okay.
  • You may only fly six weeks after surgery.
  • Do not participate in vigorous physical activity, including sports, until you have a post-operative visit with your doctor. You may return to work or school if your overall condition permits. After three weeks, you may resume all of your activities, including sports and physical exercise.
  • Your hearing may be worse immediately after surgery. This is due to blood accumulation within the middle ear space.
  • You may hear various noises in the ear, such as cracking or popping. This is part of the normal healing process.
  • Dizziness or lightheadedness, sometimes even true vertigo (spinning), is normal for up to two weeks following surgery.

Home care after the first few days

  • Pain may subside gradually. Pain relief medications may be continued if the pain persists. It is normal for the top half of the ear to feel numb and this will take several months to return to normal.
  • There may be a change in taste (usually described as metallic) on one side of the tongue and this usually improves within several months.
  • Within two to three weeks, the Steri-Strips may be removed by the doctor.
  • After the Steri-Strips are removed, the incision site may be cleaned gently with peroxide once or twice daily until no crusting is noted. A thin layer of antibiotic ointment is helpful for seven days after removing the Steri-Strips.

Emergency

The patient may need to contact the doctor immediately if they develop any of the following

  • Increased pain that is not relieved by prescription medications
  • Large amounts of bleeding from the ear area
  • Pus or foul-smelling drainage from the ear
  • Redness in the ear area
  • Temperature over 100°F on two consecutive readings
  • Severe dizziness

What is endolymphatic decompression surgery?

An endolymphatic shunt or decompression surgery is a procedure that involves placing a small silicone tube in the inner ear to drain excess fluid. This procedure can reverse the damage to the ear due to fluid buildup. It can also provide relief from associated symptoms, such as hearing loss and dizziness. A small amount of bone is removed around the endolymphatic sac (the fluid-filled sac-like structure in the inner ear). This process reduces the pressure of the fluid in the sac. The procedure is performed under general anesthesia. Decompression of the endolymphatic sac involves reducing pressure in this space. It is considered a conservative procedure because of the low rate of hearing loss and high success rate of vertigo control.

Reason for surgery

Endolymphatic sac decompression is the most appropriate for patients who are experiencing vertigo (dizziness and room spinning episodes) attacks associated with Meniere disease (a disorder affecting the inner ear). Meniere disease may present with the following symptoms

  • Hearing loss that is inconsistent (comes and goes on its own)
  • Tinnitus (ringing, buzzing or hissing noises within the ears)
  • A feeling that the ears are obstructed or plugged
  • Vertigo (a sensation that the surroundings or oneself is revolving or spinning)

What is the outcome of endolymphatic decompression surgery?

Endolymphatic shunt surgery is considered a low morbidity procedure. It has been reported to achieve complete or substantial control of vertigo in 81 percent of patients, with significant improvement in hearing in about 20 percent. Overall, there is a 60 percent chance of curing vertigo, a 20 percent chance that the attacks will remain at the same level of severity, and a 20 percent chance that the attacks will get worse. The patient's vertigo usually improves even if the hearing does not improve.

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References
Medscape Medical Reference

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