Myringotomy

Myringotomy is a surgical procedure in which a small incision is made in the tympanic membrane (eardrum) to relieve pressure, drain fluid from the middle ear, or obtain a specimen for testing. It is most commonly performed to treat middle ear effusion and recurrent acute otitis media and is typically done on an outpatient basis. In children, the procedure is usually performed under general anesthesia; in adults it may be done with local anesthesia.

Indications include persistent or recurrent middle-ear effusion causing hearing loss or balance issues, chronic otitis media, or recurrent acute otitis media unresponsive to medical treatment. It may also be used to facilitate delivery of medications into the middle ear or to relieve barotrauma in select cases.

Technique involves creating a small incision in the tympanic membrane’s pars tensa to allow drainage of middle-ear fluid. Suction or gentle aspiration is often used. In many cases a tympanostomy tube is inserted through the incision to ventilate the middle ear and permit ongoing drainage; in other cases no tube is placed and the incision may heal spontaneously. The procedure typically lasts 10 to 20 minutes.

Postoperative care emphasizes keeping the ear dry for a period and avoiding inserting objects into the ear. Follow-up is important to monitor healing and tube status if tubes were placed. Tympanostomy tubes commonly remain in place for several months before extrusion.

Risks include perforation or scarring of the tympanic membrane, persistent perforation, infection, bleeding, temporary or, rarely, prolonged hearing changes, and tube-related issues such as blockage or premature extrusion.