Myringotomy

A myringotomy is a surgical procedure in which an incision is created in the eardrum (tympanic membrane) to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear.

A tympanostomy tube may be inserted through the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid.

Before the invention of antibiotics, myringotomy without tube placement was also used as a major treatment of severe acute otitis media (middle ear infection).

In 1649, Jean Riolan the Younger accidentally pierced a patient's eardrum while cleaning it with an ear spoon.

[5] In particular, the animal experiments of Thomas Willis were expanded upon by Sir Astley Cooper, who presented two papers to the Royal Society in 1801 on his observations that myringotomy could improve hearing.

Second, he demonstrated that deafness caused by obstruction of the Eustachian tube could be relieved by myringotomy, which equalized the pressure on each side of the tympanic membrane.

An inherent problem became recognized, namely the tendency of the tympanic membrane to heal spontaneously and rapidly, reversing the beneficial effects of the perforation.

Any fluid that is present is then aspirated, the tube of choice inserted, and the ear packed with cotton to control any slight bleeding that might occur.

This perforation remains patent for several weeks and provides ventilation of the middle ear without the need for tube placement.

One randomized controlled study found that laser myringotomies are safe but less effective than ventilation tube in the treatment of chronic OME.

Some practitioners use topical antibiotic drops in the postoperative period, but research shows that this practice does not eradicate the bacterial biofilm.

[20] Evidence suggests that tympanostomy tubes only offer a short-term hearing improvement in children with simple OME who have no other serious medical problems.