Myringotomy, Here's What You Should Know

Myringotomy is an operation to make a hole in the eardrum or tympanic membrane. In this procedure, the doctor makes a small incision in the eardrum to drain fluid that has accumulated in the middle ear.

Myringotomy is generally performed to treat recurrent or long-lasting otitis media. Otitis media is a middle ear infection which can cause fluid buildup and quite severe pain

Myringotomy, Here's What You Should Know

This tube functions to circulate air to the middle ear and prevent fluid buildup in that area

Purpose and Indications of Myringotomy

To determine myringotomy, the doctor will ask about the patient's complaints and examine the condition of his ear with an otoscope. The doctor may also order a hearing test, as well as a tympanogram, which is an examination to measure how well the eardrum responds to changes in pressure.

Myringotomy aims to remove fluid that has accumulated in the middle ear. The fluid that is released can be water, blood, or pus. Myringotomy may also be performed for the following purposes:

  • Recovering hearing loss due to fluid buildup
  • Treats ear infections that do not improve with other treatments
  • Take a sample of fluid from the middle ear, to detect whether there are bacteria or viruses that infect it

Myringotomy can be performed on anyone, both children and adults. However, ENT doctors will generally perform a myringotomy on someone who has the following conditions:

  • Middle ear infection (or lasts a long time
  • Bleeding in the ear from an injury, severe infection, or a ruptured eardrum
  • Hearing impairment
  • Disorder of balance
  • Ear pain due to drastic changes in air pressure (barotrauma)

Especially for children, myringotomy can also be done to treat otitis media in children with the following conditions:

  • Hearing impairment
  • Speech delay
  • Decreased achievement in school
  • Autism
  • Abnormalities of the skull and facial bones (craniofacial disorder), which interfere with the function of the eustachian tube in equalizing pressure from inside and outside the ear

Warnings and Don'ts of Myringotomy

Although generally anyone can do it, myringotomy cannot be done in patients who have tumors or blood vessel abnormalities in the middle ear. In addition, the doctor may delay the myringotomy procedure if the patient is undergoing radiotherapy, especially in the head or neck area.

Before Myringotomy

Before undergoing a myringotomy, patients need to inform the following:

  • Medications you are currently taking
  • Illnesses that the patient and his family have suffered or are currently suffering from
  • History of allergies to latex, adhesives, antiseptics, or drugs, such as antibiotics or anesthetics

Patients will generally be asked not to eat and drink after midnight before surgery. Patients will also be advised to invite their closest family or friends so they don't have to drive alone

Myringotomy Procedure

Myringotomy can be done at the nearest hospital. Although it can be performed under local anesthesia (the patient is awake), a myringotomy is generally preceded by general anesthesia (the patient is sleeping). During the procedure, the doctor will monitor the patient's heart rate, blood pressure, and respiratory rate

After the anesthetic works, the doctor will perform several stages of myringotomy, namely:

  • Tilts the patient's head towards the non-operated ear
  • Monitor the condition of the ear canal with a microscope
  • Holds the ear canal open with an instrument called a speculum
  • Cleaning the earwax until the eardrum is clearly visible
  • Slices the eardrum by 3–5 mm
  • Sucking out fluid from the middle ear
  • Inserting a small tube into the opening of the eardrum if a myringotomy is performed with a tympanostomy

After the above procedure is complete, the doctor will cover the ear with gauze. The incision made in the eardrum does not need stitches, as it closes on its own in 4 weeks, or 6–12 weeks if a tube is placed (tympanostomy).

The whole myringotomy procedure generally takes 15–20 minutes.

After Myringotomy

Patients who have undergone myringotomy will be taken to the treatment room. During the recovery period, the doctor will monitor the condition of the patient who is still under the effects of the anesthetic. The doctor will also make sure the patient does not experience complications.

Once awake, the patient may feel more tired and sleepy throughout the day. The patient will also feel that his ear is blocked by something. However, this condition will disappear by itself after a few days.

In most cases, doctors have allowed their patients to return to their activities 1-2 days after undergoing surgery. The doctor will also tell a number of things that the patient needs to do after undergoing a myringotomy, namely:

  • Go to see a doctor 2–3 weeks after surgery
  • Consuming drugs that have been prescribed by a doctor, for example antibiotics
  • Change the gauze regularly
  • Don't submerge your head in water
  • Using earplugs (earplug) when swimming

Patients generally recover within 4 weeks. Specifically for patients undergoing myringotomy with tympanostomy, the tube that has been placed in the eardrum must be removed after 12 weeks.

Myringotomy Complications or Side Effects

Just like any other surgical procedure, myringotomy can cause some complications. Some complications that may occur as a result of this procedure are:

  • Permanent hole due to an unclosed incision
  • The eardrum hardens resulting in hearing loss
  • Injury to the ear canal
  • Heavy bleeding
  • Infection
  • Ear discharge constantly

Immediately consult a doctor if you experience the following symptoms:

  • Pain that does not improve despite treatment
  • Red or swollen ears
  • Discharge or blood from the ear
  • Signs of infection, such as fever or chills
  • Hearing impairment
  • Nausea and vomiting
  • Cough
  • Shortness of breath
  • Chest pain
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