Tuesday, July 11, 2006

That purple stuff

Q: You're a hoot! Wish my ENT had as much personality. I try to make him laugh! Rarely works.

I am asking you this question as I neglected to ask him tonight. I had down wall Cholesteatoma surgery four years ago. I am scheduled for a mastoidectomy, tympanoplasty and meatoplasty next month. Between the surgery date and my schedule to fly ( short distance, one hour flight ) it is exactly one month. Would you give the okay to fly after only one month of the above procedures?

Also what is the purple stuff he puts in my ear. He said it was an ancient Chinese secret. Okay. He may be a little funny! '-)
Thank you!

A: Some definitions for those folks who haven't heard of these things.

The best definition for cholesteatoma is "skin growing where skin does not belong." Most commonly, we're talking about skin growing in the middle ear space. Skin is stupid; skin doesn't know any better than to make more skin. That's what skin does. And so you get this ever-growing ball of skin in a location where any mass can cause trouble (injury to the sense of hearing, or to the sense of balance, or to the facial nerve, or to the brain).

Mastoidectomy refers to an operation in which the surgeon drills out the mastoid bone (the bone behind/below the ear). In this case, it's done to eradicate the cholesteatoma. A canal wall down mastoidectomy is an operation in which the posterior wall of the ear canal is removed as part of the procedure. As a result, the patient will forever after have a large cavity as part of his ear canal (where before, he had a tube).

Tympanoplasty is an operation to fix the ear drum (and sometimes the middle ear bones); meatoplasty is an operation to enlarge the ear canal opening.

To answer your first question: I would say yes, it's okay to fly, but you really need to ask your ENT. There may be details specific to your situation which might result in a different answer. Also, different surgeons have different philosophies about after-care. Ask his nurse to ask him.

That purple stuff: it's a dye called gentian violet. It has antifungal properties. It also stains EVERYTHING, which is why I don't use it. Nasty, nasty stuff; I prefer to use antifungal foot powders (like Tinactin) or CSF powder (if I remember correctly: chloromycetin, sulfanilamide, and fungizone). If I used gentian violet, all my shirts would be purple. Or mostly purple.

Any more questions?



At 9:21 AM, Blogger Kitchen Queen said...

"Any more questions?"

Okay, I'll bite. When you said you use antifungal foot powders, did you mean you use them in people's ears for infections?

At 5:55 PM, Anonymous Doug Hoffman said...

Yes, I do. Sorry it has taken me so long to answer!

At 2:15 AM, Anonymous Anonymous said...

Hey there. My husband recently had surgery to remove 2 cholesteatoms, one of which went to the sigmoid sinus and above the jugular vein. The doctor preformed a radical mastoidectomy and bone reconstruction and large/wide meatoplasty. My question....How much pain is normal following such a procedue? Our doctor made us feel like drug seekers because he need 2 percocet q 4 hours. She said he must have a low tolerance for pain and her other pts do not complain of such pain and refused to give him anything but 1 vicodin q 4 hrs. I know my husband was in pain and couldn't rest or sleep for a week. Is this true?

At 3:01 AM, Anonymous Anonymous said...

Hi, I am just 3 weeks post-op from a modified radical mastoidectomy, canal wall down with malleus and incus removed. My ENT said that I too have a very low tolerance of pain. I did not sleep for a week and had to beg for medication. Even now I am still experiencing moderate pain - when will it go away?


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