Myringotomy: Ear Tube Placement for Otitis Media

Myringotomy is the most common surgical procedure for treating recurrent otitis media or otitis media with effusion. Myringotomy (also called tympanostomy) consists of making a small incision in the eardrum and vacuuming out the fluid. This may be performed alone in order to drain the fluid and examine for bacteria in the middle ear. If otitis media with effusion persists despite drug therapy, or if it is caused by anatomical problems, the physician may also perform tube placement, in which the physician inserts a small ventilation tube to allow for continuous drainage from the middle ear.

Surgery to drain the ear and implant tubes is the second most commonly performed surgery in children under two (circumcision is first). Most experts recommend the procedure if a child has fluid in the ear for at least four months and has hearing difficulties. Hearing is almost always restored after ear tube placement, and the operation can significantly improve many facets of the child's life including ear pain and infection, impaired speech, emotional distress, and limitations in activity.

Although ear tube surgery requires general anesthesia, children usually recover in a few hours. Some feel minimal discomfort afterwards and are relieved by acetaminophen, while about half of children require powerful pain relievers such as codeine. Anesthetic eardrops may be used for topical pain relief.

In most cases, the tympanic membrane pushes the ear tube out and the hole in the eardrum closes. If effusion and hearing loss persist, then the operation may be repeated (20 - 30% of children undergo a second tube procedure).

Some doctors have recommended laser procedures to relieve ear fluid. This technique has not been fully studied and the benefits are as yet unproven.

Useful Links:

For information on chronic and acute ear infections

For information on enlarged adenoids and adenoidectomy

Please see the American Academy of Otolaryngology ?Head and Neck Surgery for further information on laser-assisted myringotomy: http://www.entnet.org/Bulletin/laser_assisted_myringotomy_article.html