Myringotomy

Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum, so as to relieve pressure caused by the excessive buildup of fluid, or to drain pus. Myringotomy is often performed as a treatment for otitis media. If a patient requires myringotomy for drainage or ventilation of the middle ear, this generally implies that the Eustachian tube is either partially or completely obstructed and is not able to perform this function in its usual physiologic fashion. Before the invention of antibiotics, myringotomy was the main treatment of severe acute otitis media (middle ear infection).

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The eardrum, also called the tympanic membrane, ordinarily heals within two weeks or so of a myringotomy - unless a tube is inserted into the opening that was made or unless the opening is made with a laser. Depending on the design of the tube, a myringotomy and tube procedure can allow external ventilation of the middle ear space for weeks, months or even years. Myringotomy with tube insertion is performed for the relief of otitis media.

Although this very brief microsurgical procedure can be performed on an outpatient basis, without the need for a general anaesthetic in co-operative adults, children require a short general anesthetic for tube insertion.

Pressure equalization tubes, or myringotomy tubes, are usually placed at the time of myringotomy to stent the eardrum open. Otherwise the rapid healing of the eardrum (a few days) would necessitate future myringotomies before the underlying condition is fully treated. Most tubes are made of a synthetic plastic material, such as silicone or teflon. They typically stay in place about nine months before they are naturally extruded by the rapidly healing eardrum.

Otolaryngologists can perform myringotomy and tube placement in the clinic using a topical anesthetic, but children usually require general anesthesia or strong sedation in the operating room. Typically an operating microscope is used, but is not always necessary. Most people report rapid return of their hearing.

The most common complications to myringotomy and tube placement include early extrusion of the tube and failure of the eardrum to heal after the tube has fallen out. Rarely the tube can extrude inward into the middle ear or mastoid and therefore be retained. These complications may require additional procedures to rectify.