Parts of the Body Involved:

Eardrum
Middle ear
External ear canal

Reasons for Procedure:

• To relieve symptoms caused by pressure due to chronic fluid buildup in the middle ear that lasts 3-6 months and does not respond to non-surgical treatments
• To restore hearing loss caused by fluid build-up, and, in children, to prevent delayed speech development caused by hearing loss
• To take sample fluid from the middle ear to examine (in the lab) for the presence of microorganisms
• To place tympanostomy tubes, which help to equalize pressure, in an attempt to prevent recurrent ear infections and the accumulation of fluid behind the ear drum

What to Expect Prior to Procedure:

Your doctor will likely do the following:

Blood tests
Hearing test
Tympanogram – a test that measures how well the eardrum responds to changes in pressure. A machine called a tympanometer, which is attached to a small, soft tip that fits snugly into the ear canal, records eardrum movement, and the results are displayed on a graph.

In the days leading up to your procedure:

Do not take aspirin, aspirin-containing products, or anti-inflammatory drugs (such as ibuprofen) for one week before the procedure
Arrange for a ride to and from the procedure
Do not eat or drink anything for at least 8 hours before the procedure

During Procedure – Anesthesia

Anesthesia - General or sometimes local (by topical application)

Description of the Procedure: An instrument called a speculum is placed in the external ear canal, and an operative microscope is placed in position. Taking care not to injure the small bones in the middle ear, a tiny incision is made in the eardrum. Fluid built up in the middle ear is then drained, and in most cases, an ear tube to continue drainage is inserted and left in place. No stitches are used to close the incision; generally, the incision will heal itself. The procedure is often performed on both ears.

After Procedure – You will be taken to the post-operative area, watched for complications, and given liquids. Once your vital signs are normal (usually within 2-3 hours) you will be moved to a hospital room, or you may be sent home.

How Long Will It Take? 60-90 minutes

Will It Hurt? Anesthesia prevents pain during surgery. However, you may have minor pain after surgery, and your doctor can give you pain medication or recommend a non-prescription pain reliever to manage this discomfort. Also, lidocaine eardrops may be administered to decrease pain.

If ear tubes are inserted, you may feel popping, pulsation, clicking, or minor pain when burping, chewing, or yawning until the ear heals around the tubes.

Possible Complications: Complications from myringotomy are rare.
They may include:

Excessive bleeding
Failure of the myringotomy incision in the ear drum to heal as expected
Hearing loss
Injury to ear structures other than the ear drum
Formation of a benign middle atoma, which may damage surrounding bone
Need for repeat surgery

Average Hospital Stay: 0-1 days

Photo of an eardrum with a ventilation tube

Postoperative Care:

If cotton was placed in the ear canal to absorb post surgical drainage, change it regularly. (Drainage should end or reduce to a minimal amount within 2-3 days.)

If you are given eardrops, place 3 drops in each ear 3 times a day for 3 days after surgery.

If water gets in the ear after surgery, monitor for drainage. If drainage begins, use eardrops, and if drainage continues for 3 days, call your doctor.

To speed healing, resume normal activities as soon as possible; within 2 days after surgery.

Take any medications as prescribed by your doctor.

Use earplugs 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 eardrops, cotton, or ear plugs into the ear unless instructed otherwise by your doctor

Outcome:
Complete healing without complications should occur within 4 weeks. Pain and/or pressure in the ear due to fluid build-up should be alleviated, and hearing loss due to fluid build-up should improve as well.

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.

Call 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 in the ear increases after surgery
Drainage from ear continues for more than 4 days after surgery
Headaches, muscle aches, dizziness, or general ill feeling
Constipation or abdominal swelling
Cough, shortness of breath, chest pain, or severe nausea or vomiting

SOURCE:

Baylor College of Medicine Department of Otorhinolaryngology and Communicative Sciences

The University of Chicago Children's Hospital