Incision of the tympanic membrane with the purpose to drain suppurative or nonsuppurative effusion of the middle ear or to provide aeration in case of malfunctioning eustachian tube is defined as "Myringotomy". If small ventilation tube (grommet and other tubes) is inserted in the tympanic membrane this surgical procedure defined as "Tympanostomy".
Myringotomy (Tympanostomy) Indications
|Myringotomy (Tympanostomy) Indications - Ear Tube Insertion|
General indications for Myringotomy / Tympanostomy) are as follows:- Chronic serous otitis media
- Eustachian tube dysfunction or malfunction
- Atelectatic ear.
- Acute suppurative otitis media with severe earache with bulging tympanic membrane.
- Acute suppurative otitis media incomplete resolution with persistent conductive deafness.
- Complications of acute otitis media, e.g. facial paralysis, labyrinthitis or meningitis with bulging tympanic membrane.
Myringotomy (Tympanostomy) Contrandications
|Myringotomy (Tympanostomy) Contrandications|
Suspected intratympanic glomus tumour. Myringotomy in these cases can cause profuse bleeding.
Myringotomy (Tympanostomy) Technique
Steps of Myringotomy Operation:
|Ear Tube Insertion|
- Ear canal is cleaned of wax and debris.
- Operation is ideally performed under operating microscope using a sharp myringotome and a good suction apparatus.
- In acute suppurative otitis media, a circumferential incision is made in the posteroinferior quadrant of tympanic membrane, midway between hundle uf malleus and tympanic annulus, avoiding injury to incudostapedial joint.
- In serous otitis media, a small radial incision is given in the posteroinferior or anteroinferior quadrant and all the effusion sucked out. When ventilation tube is to be inserted, incision should be just enough to admit the tube.
Myringotomy (Tympanostomy) Risks & Complications
|Myringotomy (Tympanostomy) Risks & Complications|
Possible complications & risks of myringotomy include:- Anaesthetic complications
- Injury to the incudo-stapedial joint
- Damage to the facial nerve
- Injury to jugular bulb with profuse bleeding, if jugular bulb is high and floor of the middle ear dehiscent.
- Perforation of the tympanic membrane
- Middle ear infection
Postoperative Patient Care For Myringotomy (Tympanostomy)
|Postoperative Patient Care For Myringotomy (Tympanostomy)|
For myringotomy operation, only one week prevention of water contact to the ear is sufficient for care. Eardrum incisions usually heal rapidly. No water should be permitted to enter the ear canal for at least one week.
If a grommet has been inserted (tympanostomy operation performed), entry of water is prevented so long as ventilation tube is in position.
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Appointment Phone: +90 212 561 00 52
Mobile phone: +90 533 6550199