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Myringotomy

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by Kassir K

(Tympanostomy; Tympanotomy; Ear Tubes Surgery)

 

What to Expect

Prior to Procedure

Your doctor will likely do the following:
  • Blood tests
  • Hearing test
  • Tympanogram—a test that measures how well the ear drum responds to changes in pressure
  • Examine the external ear and the ear drum with an instrument called an otoscope
Leading up to your procedure:
  • Arrange for a ride to and from the procedure.
  • Do not eat or drink anything for at least eight hours before the procedure.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
  • Nonsteroidal anti-inflammatory medications (NSAIDs)
  • Blood thinners
  • Antiplatelets

Anesthesia

General anesthesia is most often used. You will be asleep. In some cases, a local anesthetic will be used to numb the ear.

Description of Procedure

A small microscope is placed in position to give the doctor a better view. A tiny incision will be made in the eardrum. Fluid from the middle ear will then be drained. In most cases, a small tube will be inserted and left in place. This will allow the drainage to continue.
No stitches will be used to close the incision. The incision will heal itself. The procedure is often done on both ears. Some doctors may use a laser beam to make the opening in the ear drum.
Myringotomy
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How Long Will It Take?

The surgery will last about 15–20 minutes.

Will It Hurt?

Anesthesia prevents pain during surgery. You may have minor pain after surgery. Your doctor can give you pain medication or recommend a nonprescription pain reliever to manage this discomfort. Lidocaine ear drops may also be given to decrease pain.
If ear tubes are inserted, you may feel popping, pulsation, clicking, or minor pain when burping, chewing, or yawning until the ear heals around the tubes.

Postoperative Care

After the procedure, be sure to follow your doctor's instructions, which may include:
  • If cotton was placed in the ear canal to absorb postsurgical drainage, change it regularly. (Drainage should end or reduce to a minimal amount within 2-3 days.)
  • If you are given ear drops, use as directed. You will usually put three drops in each ear, three times a day for three days after surgery.
  • If water gets in the ear after surgery, monitor for drainage. If drainage begins, use ear drops if directed by your doctor. If drainage continues for three days (or as directed), call your doctor.
  • Take any medications as prescribed by your doctor.
  • Use ear plugs as prescribed by your doctor while swimming or bathing, and avoid underwater swimming and diving unless instructed otherwise.
  • Do not clean your ear after surgery or place anything other than ear drops, cotton, or ear plugs into the ear, unless instructed otherwise by your doctor.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
Complete healing without complications should occur within four weeks. If ear tubes were inserted, they should fall out within 6-12 months. In some cases, surgery to remove the ear tubes may be necessary. Most ear drums heal normally after tubes come out, but visible scarring is not unusual.
 

RESOURCES

HealthyChildren.org - American Academy of Pediatrics
http://www.healthychildren.org

National Institute on Deafness and Other Communication Disorders
http://www.nidcd.nih.gov

 

CANADIAN RESOURCES

Canadian Society of Otolaryngology
http://www.entcanada.org

Hospital for Sick Children
http://www.sickkids.ca

 

References


Acute otitis media. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated June 3, 2013. Accessed September 3, 2013.


Myringotomy and PE tubes. Baylor College of Medicine Department of Otorhinolaryngology and Communicative Sciences website. Available at: http://www.bcm.edu/oto/index.cfm?pmid=16841. Accessed September 3, 2013.


Myringotomy and PE tubes. The University of Chicago Children's Hospital website. Available at: http://www.uchicagokidshospital.org/specialties/ent/patient-guides/myringotomy.html. Accessed September 3, 2013.


9/25/2013 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed/what.php: Bell L. Tympanostomy tubes in children. NEJM. 2013 Aug 12. Reviewing Rosenfeld RM et al., Otolaryngol Head Neck Surg 2013 Jul 149:8.

 

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