Postoperative Discomfort after Transcanal Endoscopic Ear Surgery Assessed Longitudinally by Daily Text Message Survey

By June 7, 2019

Chiang, Harry1; Yu, Michelle1; Chun, Michael1; Kaczmarczyk, Karolina2; Golub, Justin1
1 Department of Oto/laryngology – Head & Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States;
2 Columbia College, Columbia University, New York, NY, United States.

Introduction:
A key advantage of transcanal endoscopic ear surgery (TEES) is avoidance of the recovery associated with a postauricular incision. However, this theoretical advantage has been incompletely characterized. We report the use of a novel text message strategy to longitudinally track postoperative (PO) discomfort after TEES.

Study Design:
Prospective, non-interventional, non-randomized survey.

Setting:
Tertiary university-affiliated medical center.

Patients:
English-speaking adults undergoing TEES between November 2018 and November 2019.

Methods:
Questionnaires were sent daily for 1 week PO using mobile phone text messages (SMS) to assess pain and numbness on a numeric rating scale (NRS) from 0 (absent) to 10 (maximum). A longer questionnaire was distributed in person at the first PO appointment to assess average PO pain and numbness, location of symptoms, and difficulty with various daily activities.

Results:
Of 12 patients surveyed via SMS, 8 provided partial-to-complete responses. All patients who received the longer questionnaire provided complete responses. Average PO pain and numbness on day one was 1.5±0.8 (SE) and 1.3±0.7, respectively. Average postoperative pain and numbness at the end of one week decreased to 0.7±0.7 and 0.7±0.7, respectively. Patients cited eating, wearing glasses, and difficulty sleeping, as the cause of discomfort.

Conclusion:
SMS is an acceptable method to survey patients longitudinally about PO symptoms. Pain and numbness were very low the day after surgery and nearly absent several days later. These results will inform the design of a larger controlled study to further explore PO discomfort after TEES compared to microscopic surgery.