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 is inserted into this hole to empty the fluid in many of the patients.
Why myringotomy is needed?
It may be required if:
- 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
- There is unequal pressure and this is corrected by placing a tympanostomy tube
- 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.
If the patient is on some medications, he may be recommended to halt the use of certain medications which may affect the intervention, viz. Anticoagulants, antiplatelets, or some NSAIDs.
During the Intervention
Anesthesia is given first, then a microscope of small size is put in a situation that gives a good view. Then using a very fine instrument, a tiny incision is prepared in the eardrum. Nowadays, the laser is also being used for making the hole in the eardrum. Then a tympanostomy tube is placed in the hole, which drains the fluid. After the drainage is complete the wound is left to heal by self. The whole process takes about 15-20 minutes.
During the procedure, the pain is managed by anesthesia and for pain which the patient may feel after surgery is managed by painkillers or topical anesthetic agents.
There may be some discomfort in patients with tympanostomy tubes, which subsides with the healing around the tubes.
After the Procedure
The patients are asked to follow:
- Instructions on bathing, swimming and taking medications are given, which are to be adhered to by the patient
- Instructions on changing the cotton plugs will be explained
How long it takes to heal?
Within 3-4 weeks complete healing is expected, if there are no complications encountered. The tympanostomy tubes come out and fall in 6 to 12 months time.
Some patients may require surgery after removal of the tubes.
Risks of surgery
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.
When to Call?
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