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Myringotomy

Myringotomy is a surgical incision into the eardrum to relieve pressure and drain fluid from the middle ear. It is indicated for acute or recurrent otitis media with a bulging eardrum, otitis media with effusion, and aero-otitis media. Contraindications include signs of a middle ear mass or vascular anomaly. Complications can include further middle ear infection, injury to the incudostapedial joint or stapes causing hearing loss, or injury to a high jugular bulb causing bleeding.

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shaheer Hassan
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108 views11 pages

Myringotomy

Myringotomy is a surgical incision into the eardrum to relieve pressure and drain fluid from the middle ear. It is indicated for acute or recurrent otitis media with a bulging eardrum, otitis media with effusion, and aero-otitis media. Contraindications include signs of a middle ear mass or vascular anomaly. Complications can include further middle ear infection, injury to the incudostapedial joint or stapes causing hearing loss, or injury to a high jugular bulb causing bleeding.

Uploaded by

shaheer Hassan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Myringotomy

Shaheer Hassan 2023084


Objectives:

• To discuss in the indications, contraindications and complications.


surgical incision into the
eardrum
• Primarily to
1) relieve pressure
2) drain suppurative or
nonsuppurative effusion
3) provide aeration along
with Ventilation tube
(grommet) insertion if need be
Indications

• Acute suppurative otitis media.


I. Severe earache with bulging tympanic membrane.
II. Incomplete resolution with opaque drum and persistent conductive deafness
III. Complications of acute otitis media, e.g. facial paralysis, labyrinthitis or meningitis
with bulging tympanic membrane.
IV. Recurrent acute otitis media.
• Aero-otitis media (to drain fluid and “unlock” the eustachian tube).
traumatic inflammation of the middle ear resulting from differences
between atmospheric pressure and pressure in the middle ear and occurring
in high-altitude flyers, caisson or tunnel workers, and deep-sea divers
Atelectatic ear (flaccid)
• grommet is often inserted for Longterm aeration).
• From long standing Eustation tube disorder.

• Otitis media with effusion.


PITFALLS OF MYRINGOTOMY
• When tympanic membrane is thick, incision may remain only in the
superficial layers of drum head without cutting through its entire
thickness.
• Incision in the posterior meatal wall. This may happen when distinction
between drum head and posterior meatal wall is lost, when both are
inflamed.
• Beware of vascular anomalies of the middle ear such as high jugular
bulb, aberrant carotid artery or glomus tympanicum (benign neoplasm
of middle ear)
Contraindications

• sign of middle ear mass, malignancy - glomus tumor


• vascular anomaly (high-riding jugular bulb, or displaced internal carotid
artery)
• Prior head and neck radiotherapy
Complications

1. Middle ear infection

2. Injury to incudostapedial joint & stapes.


- subsequent conductive hearing loss
3. Injury to jugular bulb with profuse bleeding,
if jugular bulb is high and bony floor of the middle ear
dehiscent (split)
• Diseases of Ear, Nose and Throat by dhingra
• KLM anatomy
• https://medicalaffairsdocs.ucsf.edu/sites/g/files/tkssra2526/f/
References wysiwyg/Standardized_Procedures/Myringotomy%20(Adult,
%20Peds).pdf

Thank you.

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