Myringotomy Surgery – The Procedure
The procedure of myringotomy is an elective procedure that is done only after medications fail to improve the condition.
The patient is first given premedication in order to relax before being taken to the operating room. However, premedication is mostly given to children as they are very anxious and fearful of the surgery.
The procedure begins with administering topical anesthesia, though small children usually need general anesthesia. The anesthesia takes effect within 10-15minutes. Other factors like the cardiac rhythm (EKG) and pulse oximeter are monitored throughout the surgery by the surgical team.
Anesthesia is followed by an incision made on the tympanic membrane or the eardrum as it is commonly called. The fluid from the middle ear is then drained through this incision. A tympanostomy tube made of either synthetic plastic, like silicone or teflone, or metal is inserted through the incision. Ear drops are then instilled followed by plugging the ear canal with a cotton plug. The tube is generally left in place until it falls off on its own, usually within 2-24 months; mostly when the patient does not require it anymore. In case it fails to fall off even after 2 to 3 years, then it needs to be removed surgically. During this time a follow-up is necessary at least every 6 months.
In more recent times, another less invasive procedure is performed called the LAM surgery or Laser Assisted Myringotomy. In this procedure, instead of making an incision, a laser is used to make an aperture. This surgery is a much more convenient method as it can be carried out in an office setting or even on an outpatient basis using only topical anesthesia. This process uses a carbon dioxide laser to make a hole on the tympanic membrane, which is of the exact size that is required. This is then left open for a few weeks. Since at this time the middle ear is well ventilated, it provides quick relief from the pain in otitis media thereby aiding the infection to heal rapidly. If the infection requires more time for healing, the tubes can be easily inserted into the bloodless holes. Research has shown that usage of this treatment reduces the recurrence of pain in the mid ear in most cases.
Risks and complications
Though myringotomy is a very common surgery, certain difficulties may be faced as after effects of it. These could be as listed below:
• Inability to heal the eardrum.
• Ear infection.
• Thickening of the eardrum.
• Tiny pores being formed after the tubes fall off.
• Inability to hear.
• Need for a more grave surgery of the adenoid, tonsil etc.
• Scarring of the eardrum.
• Chronic ear drainage.
• Possible allergic reaction to the tympanostomy tube itself.
However, these side effects are not found in Laser Assisted Myringotomy.