Procedures Surgeries - Myringotomy

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.

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