Myringotomy

Myringotomy is a surgical intervention to form a hole within the eardrum to enable the drainage of fluid/pus/blood from the middle ear. A little tube helps to empty the fluid in many cases.

Required when:

•  There is chronic fluid formation inside the middle ear, which is causing loss of hearing

• There is an indication of delay in the development of voice (speech) due to hearing loss

• Tympanostomy tube helps in correcting the pressure differences

• There is complain of persistent ear infection or infection not responding to antibiotics

• To perform fluid aspiration for culture/sensitivity testing

Before intervention, an examination by otoscope is done to evaluate the eardrum and external ear, and a tympanogram is performed to see the response of eardrum to the pressure changes and then the hearing test is performed. The doctor may recommend blood tests.

Doctor will advise keeping nil by mouth for at least 8 hours before taking up the intervention.

Following medications are advised to stop before the surgery, some of them include – Anticoagulants, antiplatelets, or some NSAIDs.

Microscope insertion is done after administration of anesthesia. This microscope helps in better visualization of the situation.  The incision on the eardrum is made by a very fine instrument. Recently, the laser is used for such precision incision.

Tympanoplasty tube placed inside the hole, enables fluid drainage. The wound heals by itself after complete drainage. The whole process takes about 15-20 minutes.

For pain during the procedure, anesthesia is more than enough. Painkillers or topical anesthetic agents provide pain relief after the surgery.

There may be some discomfort in patients with tympanostomy tubes, which subsides with the healing around the tubes.

The patients are asked to follow:

•  Patient receives instructions on bathing, swimming and routine medications
• Patient receives instructions on changing cotton plugs

Healing takes place within 3-4 weeks in case of no complications. The tympanostomy  tubes come out and fall in 6 to 12 months’ time.

Some patients may require surgery after removal of the tubes.

Generally, there are no major risks, but some likely risks are Bleeding, scarring, failure of the procedure, loss of hearing, damage or injury to organs of internal ear and there may be need for surgery in some cases.

If the patient sees any of the following, the doctor should be immediately called: 

• Signs of any discharge for a period more than expected

• Increase in pain or bleeding from ear

• Debilitating pain not controlled by medication

• Reduction in the hearing

• Any other untoward event