Myringotomy

Definition :

It is the incision of the tympanic membrane with the purpose to drain suppurative or non-suppurative effusion of the middle ear or to provide aeration in case of malfunctioning eustachian tube.

Indications :

1. Otitis media with effusion
2. Barotraumatic otitis media
3. Acute suppurative otitis media
4. Atelectatic middle ear

Contraindications :

Suspected intra-tympanic glomus tumour

Anaesthesia :

In infants , children and  un-cooperative adults: Under GA

In Cooperative adults- under LA

Incisions : Already discussed before

Complications :

1. Injury to incudo-stapedial joint or stapes
2. Tympanosclerosis
3. Ossicular fixation
4. Adhesive otitis media
5. Middle ear infection
6. Scarred TM, Thin TM
7. Persistant perforation syndrome
8. Cholesteatoma formation- rarely
9. Injury to jugular bulb with profuse bleeding, if jugular bulb is high and floor of the middle ear is dehiscent

Postop care :

1. Advises as before
2. Long term antihistamines
3. Topical antibiotic drops if there is any infection
4. Suction cleaning under microscope if necessary

Normally grommet or ventilation tube will come out within 3-6 months.

In recurrent cases we can use long term ventilation tube.