iTunes DownloadMyringotomy is a procedure in which a small cut (incision) is made in the eardrum. Usually it is done in both ears although sometimes it is only needed in one ear. If there is fluid inside the middle ear space it may be removed (suctioned out) at this time through the incision.
Tympanostomy tubes can be placed into the incisions. The tubes are open at both ends and allow air to pass through. This keeps fluid from forming in the middle ear space. The tubes are left in place until they fall out or are removed by the surgeon at a later time. The procedure is usually done under general anesthesia (you are unconscious and pain-free) although in older children and adults a combination of sedation and local anesthesia can be used.
Why is the procedure performed?
Inflammation of the middle ear may be caused by a middle ear infection, allergy or obstruction of the ear's natural drainage into the back of the nose. When this inflammation remains despite adequate medical attention the fluid that is trapped behind the eardrum can become thickened.
In addition to the danger of chronic infection and the formation of scar tissue, the presence of the fluid does not allow the transmission of normal sound (this affects normal hearing). The benefits of the procedure are that hearing returns to normal and the chronic inflammation of the middle ear space is given time to heal safely. Medical management should be tried for 3 months before considering surgery.
What should I expect during the post-operative period?
The procedure is usually done under general anesthesia although in older children and adults a combination of sedation and local anesthesia can be used. The patient will be able to go home once recovery from anesthesia is complete. It is unusual to have pain or discharge from the ear in the immediate post operative period and if this occurs you should call your doctor.
There are no restrictions on diet. You can return to work or school the day after surgery. The main concern after surgery is to keep water out of the ear. You will need to wear water protective earplugs in the bath or shower. You will be able to swim but you should avoid diving and swimming under water. Air travel should not be a problem. There are commercial and custom-made earplugs available. Ask your doctor what he/she recommends.
What are the risks and complications of this procedure?
Just as there may be benefits to the procedure(s) proposed, medical and surgical procedures also involve risks. These risks include allergic reaction, bleeding, blood clots, infections, adverse side effects of drugs, heart attack, stroke, and even loss of bodily function or life, as well as risks of transfusion reactions and the transmission of infectious disease, including hepatitis and Acquired Immune Deficiency Syndrome, from the administration of blood and/or blood components.
There are also particular risks associated with the procedure(s) proposed. These risks include but are not limited to:
- Persistent Discharge: This occurs in a significant amount of cases and can usually be treated by your doctor. Prolonged discharge may necessitate removal of the tympanostomy tube. Always notify your doctor if there is discharge from the ear.
- Abnormal Tissue Growth: Reaction to the tube may cause the formation of abnormal growth of tissue around the tube's insertion in the eardrum or behind the eardrum in the middle ear space. In rare cases these tissues may need to be removed by a surgical procedure.
- Perforation: Persistent drainage or inflammation around the tube may cause a hole to remain in the eardrum after the tube is removed or falls out. If a perforation does not heal it causes a risk of infection and a decrease in hearing and may require a surgical repair. It is also possible that a tube will not heal and fall out normally. A tube that fails to fall out or moves inward and gets trapped in the middle ear may need to be surgically removed.
- Formation of Scar Tissue: Each time an incision is made in the eardrum there is the formation of some scar tissue. If the procedure needs to be repeated several times enough scarring may occur to have some effect on the hearing.
- General Anesthesia: There are risks involved with any anesthesia and you should discuss them with your anesthesiologist.
Before you agree to any operative procedure it is important to remember that each patient is different and that the outcome of any surgical procedure can never be guaranteed. You should understand that there may be complications that have not been mentioned and that it is not possible to anticipate all complications or to answer each and every question. Again, you should be aware that in the practice of medicine unforeseen and unexpected risks or complications not previously discussed may occur. You should also understand that during the course of the proposed procedure(s), unforeseen conditions may be revealed requiring the performance of additional procedures, and such procedures may need to be performed.
Keep in mind that there is no substitute for an open and honest discussion with your own surgeon/physician regarding this procedure.
You should also be given any available treatment alternatives to this procedure by your doctor. Be sure to discuss any questions or concerns with your doctor.
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