What is myringotomy?
Myringotomy is an incision made on the tympanic membrane to drain out suppurative (made up of pus) or non-suppurative middle ear effusion. This procedure can be done along with insertion of ventilation tube (Grommet).
What are the indications for performing a myringotomy?
Following are the indications of performing a myringotomy:
1) Acute otitis media, not having responded to medical line of treatment
2) Serous otitis media
3) Atelectatic ear: For aeration of the middle ear with grommet insertion
4) Persons with eustachian tube dysfunction or malfunction.
How is myringotomy done? What is the procedure?
Following is the procedure for a myringotomy:
Anaesthesia: Usually general anaesthesia is preferred especially in children and in persons with acute inflammation. Local anaesthesia can be given in co-operative adults.
Incision: This is made by a sharp instrument called myringotome. The site of incision depends on the type of otitis media:
1) In serous otitis media, a small radial incision can be made in the antero-inferior or antero-superior quadrant. The radial incision separates rather than cuts through fibres of the middle fibrous layer. Hence, healing is with minimal scarring.
2) In acute otitis media, a circumferential incision is made in the postero-inferior quadrant of the tympanic membrane. The thick fluid present in the middle ear will ooze out through the incision.
3) Gentle suctioning of this fluid may be done
4) A ventilating tube (grommet) may be inserted through this incision.
What are the contraindications for a myringotomy?
Intra-tympanic glomus tumour can cause profuse bleeding and hence a myringotomy is contraindicated in such cases.
What are the possible complications of myringotomy?
Possible complications of a myringotomy include:
1) Anaesthetic complications
2) Injury to the incudo-stapedial joint
3) Damage to the facial nerve
4) Injury to the jugular bulb
5) Perforation of the tympanic membrane
6) Middle ear infection.