Can Prolonged Ear Packing After Cholesteatoma Surgery Lead to Recurrence?

Q: Can Prolonged Ear Packing After Cholesteatoma Surgery Lead to Recurrence?

Hello： The recurrence of cholesteatoma is related to whether it has been completely removed during surgery, and is not related to the duration of packing the ear canal with cotton or gauze. <br>There is no need to worry too much. <br>Wishing you peace and good health. <br>Sincere

If the ear canal was filled with Gelfoam and Vaseline gauze strips after cholesteatoma removal surgery and they were not removed within 3 weeks, but instead delayed by 1-2 weeks, is there a possibility of cholesteatoma cells recurring? Thank you for your response; I greatly appreciate it?

Dear Dr.
Zheng,
My mother underwent a tympanomastoid surgery for cholesteatoma on the morning of May 5th this year.
Her follow-up appointment was originally scheduled for May 25th, but it was delayed by a week.
During this time, she continued to use ear drops.
Due to the one-week delay in her follow-up, the ear canal was filled with Gelfoam and Vaseline gauze, which could not be removed within the three-week period.
It was only removed 1-2 weeks later.

I am concerned whether the prolonged presence of the packing in the ear canal could make it difficult to remove or potentially lead to a recurrence of the cholesteatoma, rendering the surgery ineffective.
Are there any remedial measures we can take? I would greatly appreciate your guidance.

Mr. Chen, 40~49 year old female. Ask Date: 2017/06/02

Dr. Zheng Jueyi reply Otolaryngology

Hello: The recurrence of cholesteatoma is related to whether it has been completely removed during surgery, and is not related to the duration of packing the ear canal with cotton or gauze.
There is no need to worry too much.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/06/02

More Info

Prolonged ear packing after cholesteatoma surgery is a concern for many patients and their families, especially when there are delays in follow-up appointments. However, it is important to understand the relationship between ear packing duration and the potential for cholesteatoma recurrence.

Cholesteatoma is an abnormal skin growth in the middle ear that can lead to various complications, including hearing loss, infections, and damage to surrounding structures. The primary goal of surgery is to remove the cholesteatoma completely and reconstruct the ear to prevent recurrence. The use of packing materials, such as Geifoam or Vaseline gauze, is common practice after surgery to help control bleeding, support healing, and maintain the shape of the ear canal.

In the case presented, the delay in removing the ear packing for an additional week beyond the recommended time frame raises concerns. However, as Dr. 鄭爵儀 indicated, the recurrence of cholesteatoma is more closely related to the completeness of the initial surgical removal rather than the duration of ear packing. If the cholesteatoma was adequately excised during the surgery, the risk of recurrence is not significantly increased by the prolonged presence of packing material.

That said, prolonged packing can lead to other issues, such as discomfort, increased risk of infection, or even the formation of granulation tissue, which could complicate the healing process. If the packing material becomes difficult to remove due to prolonged placement, it is essential to consult with the surgeon for appropriate management. In some cases, the surgeon may need to intervene to safely remove the packing and assess the ear canal's condition.

To mitigate any potential complications from prolonged packing, patients should monitor for signs of infection, such as increased pain, discharge, or fever, and report these symptoms to their healthcare provider promptly. Additionally, maintaining regular follow-up appointments is crucial for monitoring healing and addressing any concerns that may arise.

In summary, while prolonged ear packing after cholesteatoma surgery is not ideal, it does not inherently lead to recurrence of the cholesteatoma if the initial surgery was successful. However, it is essential to address any discomfort or complications that may arise from the extended packing duration. Open communication with the healthcare provider is key to ensuring the best possible outcome and addressing any lingering concerns about the surgery and recovery process.

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