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A myringotomy is a surgical procedure in which a small incision (cut) is made on the eardrum to remove any accumulated fluid, blood, or pus from the middle ear.
It is generally followed by placing a ventilation tube over the eardrum. This procedure relieves the pressure buildup in the ear that may be caused because of severe middle ear infections. Myringotomy surgery is generally considered to:
- Treat ear infections that have not responded well to other treatments
- Improve the hearing loss due to fluid buildup
- Improve the speech development delayed by hearing loss
- Treat recurrent eustachian tube or eardrum dysfunction
- Treat congenital ear problems (by birth)
During the procedure:
- The heart rate, blood pressure, and respiration of the individual are monitored, and the patient is usually given local anesthesia to numb the pain.
- The surgery usually lasts less than 30 minutes.
- The ENT (ear, nose, and throat) surgeon uses a microscope to look into the ear.
- A small incision is then made in the eardrum to clear fluid in the middle ear.
- A special pressure-equalizing (PE) tube is then placed into the incision where it remains without the use of stitches. The tube allows fluid to drain out of the middle ear. This helps prevent future infections. PE tubes usually stay in place for 1-2 years. Usually, they move from the eardrum to the ear canal and then fall out. Rarely, the tubes stay in for more than 2 years and need to be surgically removed.
The benefits of myringotomy surgery may include:
- Fewer and less severe ear infections
- Hearing improvement
- Improvement of speech
The risks include but are not limited to:
- Difficulty related to anesthesia
- Failure of the incision to heal after the tube falls out (eardrum perforation)
- Scarring of the eardrum
- Severe pain and infection
- Tubes falling out early, requiring that another set be inserted
- Failure of the tube to fall out, requiring a simple procedure for removal
Recovery:
Most patients usually recover quickly and can go home the same day. Patients usually return to their usual activities the next day. However, a few patients complain of drowsiness, weakness, and constant nausea. Some patients may have a mild earache for a few hours after surgery, which is usually treated with painkillers, such as Tylenol (acetaminophen). Patients may also be placed on antibiotics if necessary.
- Follow the dosage instructions as instructed by the doctor.
- Fluid may drain from the ears for a couple of days; the patient may wipe it away with dry cotton wool. However, one should not squeeze water into the ear.
- If the patient’s ear keeps draining for more than 3 days, the patient might need to see the doctor.
- Patients may be given eardrops to reduce the risk of infection.
- Ears should be covered when bathing or swimming to reduce the risk of a bacterial infection.
- Complications are rare but can include high fever, abnormal drainage, continuous bleeding, a permanent hole, and chronic drainage.
- Hearing loss associated with the fluid buildup goes away immediately after surgery.
- The incision usually heals naturally.
When should I consider myringotomy?
Not all middle ear issues will require a myringotomy or ear tubes. Antibiotics, ear drops, and even small dietary changes can help with many inner ear problems. For situations where medication and other treatments will not work, a myringotomy is the next best choice. Common reasons for adults receiving ear tubes are:
- Frequent ear infection: They may cause pain and scarring in the ear. Severe conditions can block the eardrum and cause pressure built-up behind the eardrum. Myringotomy will improve ventilation and reduce the number of ear infections.
- Hearing loss: This may occur when there is a build-up of fluid behind the eardrum. Hearing loss can lead to speech delays and problems with communication. In adults, the loss of hearing can significantly affect job performance and family life.
- Loss of balance: Excess fluid in the ear not only affects hearing but stability as well. The ear has two main functions: hearing and balance. When the ear becomes blocked, adequate sensory information does not make it to the brain. The brain will then overcompensate through leaning or eye movement to keep the body upright.
- Inner ear trauma or accident: This is the most common reason for most adults receiving myringotomy. Barotraumas are injuries sustained to the eardrum as the result of a rapid increase or decrease in air or water pressure. The most common cause is air travel and scuba diving.