• Conductive hearing loss due to TM perforation. 
  • Conductive hearing loss due to ossicular continuity or necrosis. 
  • Conductive hearing loss due to ossicular ankylosis. 
  • Chronic or recurrent otitis media. 
  • Recurrent middle ear infections due to contamination through perforation of TM. 
  • Progressive hearing loss due to chronic middle ear pathology. 
  • Perforation or hearing loss persistent for more than three months due to trauma, infection, or prior surgery. 
  • Inability to safely bathe or participate in water activities due to perforation of TM with or without hearing loss. 
  • Create a safe ear. 

Physical Examination 

  • Description of complete ear examination, including both normal and abnormal findings. 
  • Tests (required & dated within 3 months of surgery)
  • Air and bone-pure tone audiogram. 
  • SRT and discrimination.

Postoperative Observations 

  • Vertigo and nystagmus--appropriate medication. If severe, notify surgeon. 
  • Drainage--reinforce or change dressing. 
  • Jaw pain--reassure. 
  • Facial motion--notify surgeon of weakness or paralysis. 
  • Moderate tinnitus--reassure. Notify surgeon. 
  • Change or loss of sense of taste (usually will resolve over weeks to months). 

Outcome Review 

  • 2-4 Weeks 
  • Incision and ear canal--Signs of infection?
  • Inner ear-Complaint of vertigo? 
  • Beyond One Month
  • Hearing result--document with audiogram. 
  • Tympanic membrane--Is it intact?