Complications of ear surgery

There are risks with all surgical procedures. The degree of risk is related to both the specific procedure and to the underlying pathology. The patient should be given an indication of the likely risk in a sensitive way, so that they are not frightened into abandoning surgery.
A full explanation of the underlying condition will highlight the risks of leaving an ear disease untreated. Risks should be documented in the case notes and on the consent form.
The list of complications for CSOM is similar to that of the operation-the untreated disease carries similar risks as the operation.

These are:
-Hearing loss-temporary and permanent. Always obtain an audiogram at least within 3 months
of surgery, but preferably nearer to surgery and perform pre-op tuning fork tests and
document your findings
-Tinnitus-temporary and permanent.
-Vertigo and unsteadiness-temporary and permanent
-Facial nerve palsy-temporary and permanent
-Wound infection
-Need for further surgery
-Formation of mastoid cavity
-Need for ongoing care e.g. aural toilet for mastoid cavities

Inter-operative considerations
These can be avoided by taking precautions, e.g. always setting up and checking items such as facial nerve monitors yourself. The precaution undertaken in theatre, such as the use of a facial nerve monitor, should be recorded on the operation note. An inter-operative unusual finding or complications shold be witnessed and recorded by a senior colleague if available.

Immediate post-operative period
Check for facial nerve palsy in recovery.

Post-operative ward review
Facial nerve function should be checked, along with the eye movements for nystagmus. Webber's tuning fork test should be done. The patient should localise to the operated ear.