A myringotomy, also known as a tympanostomy or tympanotomy, is a surgical procedure to remove fluid in the middle ear and reestablish equal air pressure on both sides of the eardrum.
The ear consists of three main parts: the outer ear, the middle ear, and the inner ear.
The outer ear includes the pinna, which collects sound waves and the ear canal, which transports sound waves to the eardrum, a paper-thin layer of tissue separating the outer and middle ear.
Sound waves cause the eardrum to vibrate, which in turn vibrates three tiny bones inside the middle ear called the malleus, incus, and stapes,
which pass the sound vibrations along to the inner ear.
The inner ear translates vibrations into electrical signals, which are picked up by the auditory nerve, sent to the brain, and interpreted as sound.
This complex process occurs instantly allowing us to hear the sounds around us as they happen.
For the eardrum to vibrate properly, the air pressure in the middle ear must be at the same level of pressure as air outside the ear.
Air enters the middle ear through the Eustachian, or auditory, tube.
When you yawn and hear a pop, your Eustachian tube has just carried an air bubble to your middle ear to equalize the pressure.
An infection, allergy, mass, or enlarged adenoids can block the Eustachian tube, allowing fluid to collect in the middle ear.
Fluid prevents the eardrum from vibrating properly, blocking normal transmission of sound through the middle ear, which may cause hearing loss.
In some instances, the fluid may become infected with bacteria, resulting in otitis media, or ear infection.
Reasons for performing a myringotomy include: Draining ear fluid trapped in the ear for more than 3 months,
Treating chronic ear infections not cleared up with antibiotics,
Restoring hearing loss caused by fluid build-up,
Preventing delays in speech development due to hearing loss in children, or
Testing fluid from the middle ear for bacteria.
Before the procedure, an intravenous line will be started.
In most cases, general anesthesia is used to put the patient to sleep for the duration of the procedure.
The surgeon will make a small incision in the eardrum using a scalpel or laser, and drain the fluid in the middle ear.
In many cases, the surgeon will place a ventilation tube, or PE tube, through the incision.
This small tube will drain any fluid that collects after surgery and allow air into the middle ear to help dry it out.
If necessary, the surgeon will repeat the procedure on the opposite ear.
The entire procedure takes 30-60 minutes. The incision in the eardrum will heal itself, so no stitches are required.
After surgery, the patient will go to the recovery room for monitoring. Children may be fussy after their procedure, and should be encouraged to eat and drink anything they can tolerate.
If your child has pain, avoid aspirin, and instead use acetaminophen at an age-specific dose.
If additional pain relief is necessary, your doctor can recommend other options. The PE tube usually falls out on its own within several months.