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Persistent built-up of pus in the middle ear can erode the bony structures and result in the spread of infection.
Tympanostomy is a surgical procedure in which a small cut (incision) is made on the eardrum (also called the tympanic membrane) to place a small tube called the tympanostomy tube in the ear. The eardrum separates the external ear from the middle ear. It plays a role in hearing and preventing the entry of any foreign material in the middle ear. The infections of the middle ear (otitis media) may cause fluids to collect in the middle ear space. This fluid or pus can increase the pressure in the ear and hamper hearing. This is particularly worrisome in children because untreated hearing difficulties can cause delays in speech and language development. Persistent built-up of pus in the middle ear can erode the bony structures and result in the spread of infection. It puts pressure on the nerves and blood vessels, thereby damaging them. Placing a tympanostomy tube allows the fluid from the middle ear to drain out, thus relieving the pressure and limiting the spread of infection.
How is a tympanostomy done?
Tympanostomy is performed by a board-certified surgeon. It is a short surgical procedure that takes around 10 to 15 minutes. It is generally done under local anesthesia in adults. In children, however, general anesthesia (the child sleeps during the procedure) is administered.
Before the surgery
Your doctor may:
- Perform an ear examination (otoscopy).
- Order some blood tests, audiology studies, and imaging studies (such as X-ray and computed tomography or CT scan).
- Ask you of any chronic health conditions.
- Ask you about any medications you are on.
- Ask about any allergies you may have.
- Explain the surgical procedure in detail, including possible complications, and address your doubts and concerns related to the surgery.
- Obtain your written consent.
- Ask you not to eat or drink anything before the surgery.
During the surgery
The following will be done:
- You may be asked to change into a hospital gown.
- You will be made to lie on the operation table with your head turned sideways so that the ear to be operated faces upwards.
- The anesthesiologist will administer the anesthesia.
- The surgeon will apply drapes and clean the site to be operated on with an antiseptic solution.
- An operating microscope is used for the surgery.
- A special instrument called a speculum is inserted in the ear for better visualization of the eardrum.
- Cerumen or ear wax is removed to see the eardrum more clearly.
- The doctor will make a 3-5 mm surgical cut on the eardrum using a myringotomy knife.
- They will insert a tiny tympanostomy tube through the whole.
- Excess fluid may be suctioned out of the middle ear.
- The tympanostomy tube is left in place to allow drainage of fluid from the middle ear.
After the surgery:
- When this procedure is done under local anesthesia, it is a day-care procedure. If general anesthesia is administered, you will be observed in the recovery room for some time. In addition, the following things can be expected:
- The overall recovery after tympanostomy is swift.
- The doctor may prescribe antibiotic ear drops and oral pain medications after the surgery.
- You will be asked to avoid swimming underwater or diving for a few days after the surgery to prevent the entry of water in the middle ear.
- The eardrum will heal on its own and the tympanostomy tube will fall out from the ear.
What are the risks of a tympanostomy?
Tympanostomy is generally a safe procedure with minimal discomfort and risks. Some of the complications that can occur include:
- Scarring of the eardrum
- Persistent hole (perforation) in the eardrum after the tympanostomy tube falls out
- Infections
- Hearing loss
- Anesthesia-related complications
- Middle ear cyst formation