Loma Linda University Ear, Nose, and Throat Surgery offers services and procedures specializing in the branch of neurotology. Otology and Neurotology covers the diagnosis and treatment of neurological disorders associated with structures of the inner ear that result in balance disorders and hearing problems.

As experts in the field, our physicians uphold excellence in healthcare by treating patients suffering from conditions such as chronic ear infections and hearing loss with the most advanced surgical techniques and emerging technologies.

Otology and Neurotology Services and Procedures

  • Acoustic Neuroma Surgery - Also known as vestibular schwannoma, acoustic neuroma is a noncancerous tumor of the nerve connecting the ear to the brain. Acoustic neuroma surgery is required to remove the tumor from the nerve as well as prevent paralysis of the face.
  • Bone Anchored Hearing Aids (BAHA) - An implantable hearing device used for the treatment of hearing loss among patients with chronic ear infections, congenital hearing loss or one-sided deafness. BAHA works through bone conduction, in which the device directly stimulates the inner ear via the bone.
  • Cochlear Implants - A small electronic device that is surgically implanted in the ears of people who are deaf or suffer severe hearing loss. With cochlear implants, patients with hearing impairments are able to receive and process sounds and speech.
  • Mastoidectomy - A surgical procedure designed to remove infection or growths of mastoid air cells in the bone behind the ear. Its purpose is to heal the ear and prevent further damage.
  • Stapedectomy - A surgical procedure used for the treatment of otosclerosis  an abnormal bone growth occurring in the middle ear that causes hearing loss. The procedure improves hearing by removing the stapes bone, located in the inner ear, and replacing it with a small prosthesis.
  • Tympanoplasty - Reconstructive surgical procedure that corrects a tear in the ear drum or middle ear bones. Undergoing this procedure will help prevent chronic middle ear infections.

Postoperative Instructions

Tympanoplasty with/without Mastoidectomy

You will receive more specific instructions after your surgery, but the following will give you an idea of what to expect for care after surgery.

*** indicates to be determined after surgery

Hearing expectations:

Your hearing may be worse right now due to packing in the ear. It will take up to three months to establish a new baseline. Questions about specific hearing outcomes and future plans may be addressed at your follow-up appointment.

Wound care:

You have an incision inside the ear canal. The cotton ball in your ear can be changed as needed as it gets soaked with blood or drainage. You can stop using it if there is no drainage. Expect some blood (or brown, pink, yellow, black, or clear fluid) to drain from your ear canal for one to two weeks. There is packing inside the ear. It may fall out, but do not attempt to remove it. It is ok to apply ear drops directly to the packing. Not all patients will have ear drops prescribed.

If you have a head dressing and gauze around your ear, they are there to catch expected oozing and drainage, and can be removed *** days after surgery.

If you have an incision behind the ear, there may be a small amount of blood oozing from the incision for one to two days. The brown skin tape strips covering your incision behind the ear may be removed in one week if they have not come off on their own. All stitches dissolve on their own. Do not remove any stitches visible in the incision.

Common symptoms:

Pain around your surgical site will improve with time but may last up to two weeks and sometimes longer. There will be swelling behind and sometimes in front of the ear. The swelling may get a little worse about 3-5 days after surgery as the body is healing. If the swelling is severe or getting worse, please message or call your doctor. You will have numbness around your incision and ear, which will gradually improve with time. You may hear clicking, popping, pulsing, ringing, or other sounds due to the packing and healing process. You may have soreness or bruising of your lips, eyelids, and shoulders due to placement of facial nerve monitoring electrodes. You may experience jaw or neck pain due to surgical positioning. Throat pain is common after intubation for surgery. Your taste may change temporarily. You may also experience headaches and fatigue which should improve.

Common medications:

  • Ear medications: use the ear drops prescribed (usually ofloxacin or ciprofloxacin with dexamethasone) starting *** for *** days, 2 times a day, *** drops each time. Lie on the opposite side for two minutes after applying drops to allow the drops to seep inward. Wipe any excess that leak out. If different instructions are written on the ear drops bottle, follow the instructions here instead.
  • Use acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin) as needed for pain. Use prescription narcotics (e.g. Norco, Percocet) for breakthrough pain only. Some narcotics have acetaminophen included (e.g. Norco, Percocet), so do not take acetaminophen at the same time.
  • Fiber and stool softeners (e.g. docusate) may help with constipation from pain medications.
  • Anti-nausea medications may be prescribed if you have dizziness with nausea and/or vomiting.
  • Resume your home medications when you go home unless otherwise specified.

Shower/bathing

You may shower or bathe *** days after your surgery, but do not soak or scrub your wound. Dry incisions immediately after showering. Keep the inside of your ear dry AT ALL TIMES at least until your follow-up appointment, but likely for two to three months. You may use a cotton ball coated with lubricant (e.g. Vaseline) placed tightly in the outside bowl of the ear to keep water out of the ear. Do not use cotton without lubricant as it will draw water into the ear. If water gets in, dab with a dry towel but do not place anything inside the ear canal. You may use other earplugs also as long as they do not push on the packing inside the ear. Apply moisturizing lotion (e.g. Aquaphor, Cetaphil) or antibiotic ointment (if prescribed) over incisions behind the ear until they are fully healed. No need to apply lotion when incision is covered by skin tape, but apply when the tape falls off.

Activity restrictions

Do not lift anything over 20 pounds or strain for 3 weeks after surgery to decrease the chance of bleeding. Do not blow your nose. Sneeze with your mouth open. Do not strain on the toilet. You may return to work 14 days after surgery, or much sooner if you are feeling up to it (not taking narcotic pain medications) and your work does not require straining. Do not fly for one month after surgery, but call if this is unavoidable. Be careful with walking and showering as you may be dizzy or have imbalance for days to weeks after surgery. You may need someone to help with driving and other activities if you are too dizzy.

Diet

Healthy food. Maintain hydration by drinking plenty of water. Your food may taste different or you may have decreased taste for weeks to months.

Follow-up appointment: You will follow up with your doctor in clinic in ***(2-4) weeks to check on your ear and incision. Before you leave the hospital, confirm that your nurse has called to make the appointment for you. If this was not possible, call 909-558-2600 during normal business hours for an appointment.

Contact info: Message your doctor on MyChart or call the ear, nose, throat (ENT) clinic at 909-558-2600 from 8 am to 5 pm or ask for the on-call ENT physician at 909-558-4000 if the clinic is not reachable.

Please be patient as there may be a slight delay in response if you leave a message with the clinic.

Call if:

  • Temperature greater than 101.5 F
  • Difficulty eating or drinking
  • Difficulty breathing
  • Chest pain
  • Severe headache with neck stiffness
  • Persistent nausea and vomiting
  • Purulent, milky, thick, green, or foul-smelling drainage from the ear canal
  • Worsening incision redness, drainage, swelling, and pain
  • Worsening dizziness
  • If your head dressing is saturated with blood and dripping
  • Incision does not stop bleeding
  • If you have to change the cotton ball in your ear more than once an hour due to saturation with blood
  • Any other questions or concerns

Stapedotomy/Stapedectomy

You will receive more specific instructions after your surgery, but the following will give you an idea of what to expect for care after surgery.

*** indicates to be determined after surgery

Hearing expectations:

Your hearing may be worse right now due to packing in the ear. It will take up to three months to establish a new baseline. Questions about specific hearing outcomes and future plans may be addressed at your follow-up appointment.

Wound care:

You have an incision inside the ear canal. The cotton ball in your ear can be changed as needed as it gets soaked with blood or drainage. You can stop using it if there is no drainage. Expect some blood (or brown, pink, yellow, black, or clear fluid) to drain from your ear canal for one to two weeks. There is packing inside the ear. It may fall out, but do not attempt to remove it. It is ok to apply ear drops directly to the packing. Not all patients will have ear drops prescribed.

If you have an incision behind the ear, there may be a small amount of blood oozing from the incision for one to two days. The brown skin tape strips covering your incision behind the ear may be removed in one week if they have not come off on their own. All stitches dissolve on their own. Do not remove any stitches visible in the incision.

If you have a head dressing and gauze around your ear, they are there to catch expected oozing and drainage, and can be removed *** days after surgery.

Common symptoms:

Pain around your surgical site will improve with time but may last up to two weeks and sometimes longer. You may hear clicking, popping, pulsing, ringing, or other sounds due to the packing and healing process. You may have soreness or bruising of your lips, eyelids, and shoulders due to placement of facial nerve monitoring electrodes. You may experience jaw or neck pain due to surgical positioning. Throat pain is common after intubation for surgery. Your taste may change temporarily. You may also experience headaches and fatigue which should improve.

Common medications:

  • Ear medications: use the ear drops prescribed (usually ciprofloxacin with dexamethasone or ofloxacin) starting *** for *** days, 2 times a day, *** drops each time. Lie on the opposite side for two minutes after applying drops to allow the drops to seep inward. Wipe any excess that leak out. If different instructions are written on the ear drops bottle, follow the instructions here instead.
  • Use acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin) as needed for pain. Use prescription narcotics (e.g. Norco, Percocet) for breakthrough pain only. Some narcotics have acetaminophen included (e.g. Norco, Percocet), so do not take acetaminophen at the same time.
  • Fiber and stool softeners (e.g. docusate) may help with constipation from pain medications.
  • Anti-nausea medications may be prescribed if you have dizziness with nausea and/or vomiting.
  • Resume your home medications when you go home unless otherwise specified.

Shower/bathing

You may shower or bathe *** days after your surgery, but do not soak or scrub your wound. Dry incisions immediately after showering. Keep the inside of your ear dry AT ALL TIMES at least until your follow-up appointment, but likely for two to three months. You may use a cotton ball coated with lubricant (e.g. Vaseline) placed tightly in the outside bowl of the ear to keep water out of the ear. Do not use cotton without lubricant as it will draw water into the ear. If water gets in, dab with a dry towel but do not place anything inside the ear canal. You may use other earplugs also as long as they do not push on the packing inside the ear. Apply moisturizing lotion (e.g. Aquaphor, Cetaphil) or antibiotic ointment (if prescribed) over incisions behind the ear until they are fully healed. No need to apply lotion when incision is covered by skin tape, but apply when the tape falls off.


Activity restrictions

Do not lift anything over 20 pounds or strain for 3 weeks after surgery to decrease chance of bleeding. Do not blow your nose. Sneeze with your mouth open. Do not strain on the toilet. You may return to work 14 days after surgery, or much sooner if you are feeling up to it (not taking narcotic pain medications) and your work does not require straining. Do not fly for one month after surgery, but call if this is unavoidable. Be careful with walking and showering as you may be dizzy or have imbalance for days to weeks after surgery. You may need someone to help with driving and other activities if you are too dizzy.

Diet

Healthy food. Maintain hydration by drinking plenty of water. Your food may taste different or you may have decreased taste for weeks to months.

Follow-up appointment: You will follow up with your doctor in clinic in ***(2-4) weeks to check on your ear. Before you leave the hospital, confirm that your nurse has called to make the appointment for you. If this was not possible, call 909-558-2600 during normal business hours for an appointment.

Contact info: Message your doctor on MyChart or call the ear, nose, throat (ENT) clinic at 909-558-2600 from 8 am to 5 pm or ask for the on-call ENT physician at 909-558-4000 if the clinic is not reachable.

Please be patient as there may be a slight delay in response if you leave a message with the clinic.

Call if:

  • Temperature greater than 101.5 F
  • Difficulty eating or drinking
  • Difficulty breathing
  • Chest pain
  • Severe headache with neck stiffness
  • Persistent nausea and vomiting
  • Purulent, milky, thick, green, or foul-smelling drainage from the ear canal
  • Worsening incision redness, drainage, swelling, and pain
  • Worsening dizziness
  • If you have to change the cotton ball in your ear more than once an hour due to saturation with blood
  • Any other questions or concerns

Cochlear Implant Surgery

You will receive more specific instructions after your surgery, but the following will give you an idea of what to expect for care after surgery.

*** indicates to be determined after surgery

Hearing expectations:

You will have no hearing right now in the operated ear. You will not have any hearing in that ear until the external processor is placed during your next Audiology appointment. Questions about specific hearing outcomes and future plans may be addressed at your follow-up appointment.

Wound care:

Your head dressing and gauze around your ear are there to catch expected oozing and drainage, and can be removed *** days after surgery. You have an incision behind the ear. There may be a small amount of blood oozing from the incision for one to two days. The brown skin tape strips covering your incision behind the ear may be removed in one week if they have not come off on their own. All stitches dissolve on their own. Do not remove any stitches visible in the incision. You may have some orange/yellow/brown drainage from the ear canal due to the cleaning solution used during surgery.

Common symptoms:

Pain around your surgical site will improve with time but may last up to two weeks and sometimes longer. There will be swelling behind and sometimes in front of the ear. The swelling may get a little worse about 3-5 days after surgery as the body is healing. If the swelling is severe or getting worse, please message or call your doctor. You will have numbness around your incision and ear, which will gradually improve with time. You may have soreness or bruising of your lips, eyelids, and shoulders due to placement of facial nerve monitoring electrodes. You may experience jaw or neck pain due to surgical positioning. Throat pain is common after intubation for surgery. Your taste may change temporarily. You may also experience headaches and fatigue which should improve.

Common medications:

  • Use acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin) as needed for pain. Use prescription narcotics (e.g. Norco, Percocet) for breakthrough pain only. Some narcotics have acetaminophen included (e.g. Norco, Percocet), so do not take acetaminophen at the same time.
  • Fiber and stool softeners (e.g. docusate) may help with constipation from pain medications.
  • Anti-nausea medications may be prescribed if you have dizziness with nausea and/or vomiting.
  • Resume your home medications when you go home unless otherwise specified.

Shower/bathing

You may shower or bathe *** days after your surgery, but do not soak or scrub your wound. Dry incisions immediately after showering. Apply moisturizing lotion (e.g. Aquaphor, Cetaphil) or antibiotic ointment (if prescribed) over the incision until it is fully healed. No need to apply lotion when the incision is covered by skin tape, but apply when the tape falls off. It is ok if some water gets inside the ear canal but do not try to wash inside the ear canal.

Activity restrictions

Do not lift anything over 20 pounds or strain for 3 weeks after surgery to decrease chance of bleeding. Do not blow your nose. Sneeze with your mouth open. Do not strain on the toilet. You may return to work 14 days after surgery, or much sooner if you are feeling up to it (not taking narcotic pain medications) and your work does not require straining. Do not fly for one month after surgery, but call if this is unavoidable. Be careful with walking and showering as you may be dizzy or have imbalance for days to weeks after surgery. You may need someone to help with driving and other activities if you are too dizzy.

Diet

Healthy food. Maintain hydration by drinking plenty of water. Your food may taste different or you may have decreased taste for weeks to months.

Follow-up appointment: You will follow up with your doctor in clinic in ***(2-4) weeks to check on your ear and incision. Before you leave the hospital, confirm that your nurse has called to make the appointment for you. If this was not possible, call 909-558-2600 during normal business hours for an appointment. You should have a follow up appointment with Audiology as well in about 1 month.

Contact info: Message your doctor on MyChart or call the ear, nose, throat (ENT) clinic at 909-558-2600 from 8 am to 5 pm or ask for the on-call ENT physician at 909-558-4000 if the clinic is not reachable.

Please be patient as there may be a slight delay in response if you leave a message with the clinic.

Call if:

  • Temperature greater than 101.5 F
  • Difficulty eating or drinking
  • Difficulty breathing
  • Chest pain
  • Severe headache with neck stiffness
  • Persistent nausea and vomiting
  • Purulent, milky, thick, green, or foul-smelling drainage from the ear canal
  • Worsening incision redness, drainage, swelling, and pain
  • Worsening dizziness
  • If your head dressing is saturated with blood and dripping
  • Incision does not stop bleeding
  • Any other questions or concerns

Bone-Anchored Hearing Aid Surgery

You will receive more specific instructions after your surgery, but the following will give you an idea of what to expect for care after surgery.

*** indicates to be determined after surgery

Hearing expectations:

Your hearing will not change in the operated ear after surgery until the external processor is placed during your next Audiology appointment. Questions about specific hearing outcomes and future plans may be addressed at your follow-up appointment.

Wound care:

Your head dressing and gauze around your ear are there to catch expected oozing and drainage, and can be removed *** days after surgery. You have an incision behind the ear. There may be a small amount of blood oozing from the incision for one to two days. The brown skin tape strips covering your incision behind the ear may be removed in one week if they have not come off on their own. All stitches dissolve on their own. Do not remove any stitches visible in the incision. Some implants may be visible through the skin or you may have a foam dressing around the implant. If so, do not remove the dressing. You may have some orange/yellow/brown drainage from the ear canal due to the cleaning solution used during surgery.

Common symptoms:

Pain around your surgical site will improve with time but may last up to two weeks and sometimes longer. There will be swelling behind and sometimes in front of the ear. The swelling may get a little worse about 3-5 days after surgery as the body is healing. If the swelling is severe or getting worse, please message or call your doctor. You will have numbness around your incision and ear, which will gradually improve with time. You may have soreness or bruising of your lips, eyelids, and shoulders due to placement of facial nerve monitoring electrodes. You may experience jaw or neck pain due to surgical positioning. Throat pain is common after intubation for surgery. Your taste may change temporarily. You may also experience headaches and fatigue which should improve.

Common medications:

  • Use acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin) as needed for pain. Use prescription narcotics (e.g. Norco, Percocet) for breakthrough pain only. Some narcotics have acetaminophen included (e.g. Norco, Percocet), so do not take acetaminophen at the same time.
  • Fiber and stool softeners (e.g. docusate) may help with constipation from pain medications.
  • Anti-nausea medications may be prescribed if you have dizziness with nausea and/or vomiting.
  • Resume your home medications when you go home unless otherwise specified.

Shower/bathing

You may shower or bathe *** days after your surgery, but do not soak or scrub your wound. Dry incisions immediately after showering. Apply moisturizing lotion (e.g. Aquaphor, Cetaphil) or antibiotic ointment (if prescribed) over the incision until it is fully healed. No need to apply lotion when the incision is covered by skin tape, but apply when the tape falls off. It is ok if some water gets inside the ear canal but do not try to wash inside the ear canal.

Activity restrictions

Do not lift anything over 20 pounds or strain for 3 weeks after surgery to decrease chance of bleeding. Do not blow your nose. Sneeze with your mouth open. Do not strain on the toilet. You may return to work 14 days after surgery, or much sooner if you are feeling up to it (not taking narcotic pain medications) and your work does not require straining. Do not fly for one month after surgery, but call if this is unavoidable. Be careful with walking and showering as you may be dizzy or have imbalance for days to weeks after surgery. You may need someone to help with driving and other activities if you are too dizzy.

Diet

Healthy food. Maintain hydration by drinking plenty of water. Your food may taste different or you may have decreased taste for weeks to months.

Follow-up appointment: You will follow up with your doctor in clinic in 2 weeks to check on your ear and incision. Before you leave the hospital, confirm that your nurse has called to make the appointment for you. If this was not possible, call 909-558-2600 during normal business hours for an appointment. You should have a follow up appointment with Audiology as well in about 1 month.

Contact info: Message your doctor on MyChart or call the ear, nose, throat (ENT) clinic at 909-558-2600 from 8 am to 5 pm or ask for the on-call ENT physician at 909-558-4000 if the clinic is not reachable.

Please be patient as there may be a slight delay in response if you leave a message with the clinic.

Call if:

  • Temperature greater than 101.5 F
  • Difficulty eating or drinking
  • Difficulty breathing
  • Chest pain
  • Severe headache with neck stiffness
  • Persistent nausea and vomiting
  • Worsening incision redness, drainage, swelling, and pain
  • Worsening dizziness
  • If your head dressing is saturated with blood and dripping
  • Incision does not stop bleeding
  • Any other questions or concerns