Myringotomy

(Tympanostomy; Tympanotomy; Ear

Tubes Surgery)
 Myringotomy
 is a surgical procedure in which a small
incision is made in the eardrum (the tympanic
membrane), usually in both ears.
 “myringa”, modern Latin for drum
membrane
 “tome”, Greek for cutting.
 An Incision into the tympanic membrane
through which fluid is removed by suction
called myringotomy. To keep the incision open
and to prevent recurrence of fluid, various
types of transtympanic tubes can be inserted
into the incision.
 A myringotomy is a procedure to put a hole in
the ear drum. This is done so that fluid trapped
in the middle ear can drain out. The fluid may
be blood, pus, and/or water. In many cases, a
small tube is inserted into the hole in the ear
drum. The tube helps to maintain drainage.
This surgery is most often done on children,
but is sometimes done on adults.
 Indications
 To help treat an ear infection(otitis media) that is not
responding to medical treatment
 To restore hearing loss caused by fluid build-up and to
prevent delayed speech development caused by hearing
loss in children
 To take sample fluid from the middle ear to examine in
the lab for the presence of bacteria or other infections
 To place tympanostomy tubes—These tubes help to
equalize pressure. It may also help prevent recurrent ear
infections and the accumulation of fluid behind the ear
drum.
 Purpose of myringotomy
 to relieve symptoms
 to restore hearing
 to take a sample of the fluid to

examine in the laboratory in order to

identify any microorganisms present
 to insert ear tubes.
 Complications
 Bleeding
 Infection
 Failure of the myringotomy incision in the ear
drum to heal as expected
 Hearing loss
 Injury to ear structures other than the ear drum
 Need for repeat surgery
 Pre-surgical Exams
 Your doctor will likely do the following:
 Blood tests
 Hearing test
 Tympanogram—a test that measures how well
the ear drum responds to changes in pressure
 Examine the external ear and the ear drum with
a special instrument called an otoscope
 Pre-op Care
 Leading up to your procedure:
 Arrange for a ride to and from the procedure.
 Do not eat or drink anything for at least eight hours
before the procedure.
 Talk to your doctor about your medicines. You may
be asked to stop taking some medicines up to one
week before the procedure, like:Aspirin or other
anti-inflammatory drugs
 Blood thinners, such as clopidogrel (Plavix) or 
warfarin (Coumadin)
 Anesthesia
 Anesthesia
 General anesthesia is most
often used. You will be asleep.
In some cases, a local
anesthetic will be used to numb
the ear.
 Description
 A small microscope is placed in position to give
the doctor a better view. A tiny incision will be
made in the eardrum. Fluid from the middle ear
will then be drained. In most cases, a small tube
will be inserted and left in place. This will allow
the drainage to continue.
 No stitches will be used to close the incision.
The incision will heal itself. The procedure is
often done on both ears. Some doctors may use a
laser beam to make the opening in the ear drum.
 Post-op Care
 If cotton was placed in the ear canal to absorb
postsurgical drainage, change it regularly. (Drainage
should end or reduce to a minimal amount within 2-
3 days.)
 If you are given ear drops, use as directed. You will
usually put three drops in each ear, three times a day
for three days after surgery.
 If water gets in the ear after surgery, monitor for
drainage. If drainage begins, use ear drops if
directed by your physician, and if drainage continues
for three days (or as directed), call your doctor.
 To speed healing, resume normal activities as
soon as possible.
 Take any medicines as prescribed by your
doctor.
 Use ear plugs as prescribed by your doctor
while swimming or bathing, and avoid
underwater swimming and diving unless
instructed otherwise.
 Do not drive for at least 3-4 days after surgery.
 See your doctor for any needed tests.
 Do not clean your ear after surgery or place
anything other than ear drops, cotton, or ear
plugs into the ear, unless instructed otherwise
by your doctor.
 Complete healing without complications
should occur within four weeks. If ear tubes
were inserted, they should fall out within 6-12
months. In some cases, surgery to remove the
ear tubes may be necessary. Most ear drums
heal normally after tubes come out, but visible
scarring is not unusual.
 Patient Education
 Continue to blow nose gently one side at a
time and to sneeze or cough with your mouth
open for one week post surgery.
 Avoid Physical activity for 1 week and
exercise or sports 3 weeks after surgery.
 Avoid heavy lifting
 Change cotton ball daily as prescribed.
 Avoid airplane flight 1 week after surgery.
 Call the Doctor if:
 After arriving home, contact your doctor if any of the following
occurs:
 Signs of infection, including fever and chills
 Redness, swelling, increasing pain, excessive bleeding, or
discharge from the ear
 Pain that you cannot control with the medicines you have been
given
 Drainage from ear continues for more than four days after surgery
 Decreased hearing
 Cough, shortness of breath, chest pain, or severe nausea or
vomiting
 Any other new concerns
 Sources
 https://healthlibrary.epnet.com
 Black, Joyce M & Hawks, Jane H.
(2009).Medical-Surgical Nursing:Clinical
Management for Positive outcoome 8th Ed.
 http://www.entcanada.org
Thank you.