FOR THE SURGICAL MANAGEMENT OF OTITIS MEDIA WE HAVE TYMPANOCENTESIS AND
MYRINGOTOMY.
Tympanocentesis is a diagnostic and therapeutic procedure in which a needle is inserted through the
tympanic membrane to aspirate fluid from the middle ear space.
• The procedure is considered diagnostic when the material obtained is sent for laboratory and/or
microbiological analysis.
• It is considered therapeutic in most instances because it relieves pressure, thereby reducing pain and
many times shortens the course of an acute otitis media (AOM)
As you can see in the picture on the left,
This is a minor surgical procedure that involves puncturing the tympanic membrane with a small gauge
needle. So analgesia will be given before the procedure, an ear speculum is inserted into the external
auditory canal and a needle is inserted through the tympanic membrane to aspirate middle ear fluid.
The next is Myringotomy
Myringotomy is a surgical procedure of the eardrum or tympanic membrane. The procedure is
performed by making a small incision with a myringotomy knife through the layers of tympanic
membrane so fluids such as water, blood, or pus can drain out. This surgical procedure permits direct
access to the middle ear space and allows the release of middle-ear fluid to reduce pain, improve
hearing and reduce infections.
As shown in the picture, a small incision is made on the anterior inferior portion of the eardrum then a
tube will be inserted to allow air to get inside. When air is able to get behind the eardrum, the fluid
inside the ear can flow out taking away the pain or pressure and making future infections less likely. This
surgery will last about 15-20 minutes. In most cases, the ear tubes do not need to be removed and
usually are pushed out on their own after about 6 to 18 months.
