Myringotomy and Tubes
Myringotomy is the incision of the tympanic membrane (or eardrum). It is done for variety of reasons but usually in order to drain the middle ear of fluid or infection. It may also be done when no fluid is present but the tympanic membrane is retracted due to low middle ear pressure. Middle ear fluid, infection, or pressure gradients cause decreased compliance (malfunction) of the tympanic membrane and a conductive hearing loss.
Pressure equalization tubes, or myringotomy tubes, are usually placed at the time of myringotomy to stent the eardrum open. Otherwise the rapid healing of the eardrum (a few days) would necessitate future myringotomies before the underlying condition is fully treated. Most tubes are made of a synthetic plastic material. They typically stay in place about nine months before they are naturally extruded by the rapidly healing eardrum.
Otolaryngologists can perform myringotomy and tube placement in the clinic using a topical anesthetic, but children usually require general anesthesia or strong sedation in the operating room. Typically an operating microscope is used, but is not always necessary. Most people report rapid return of their hearing.
The most common complications to myringotomy and tube placement include early extrusion of the tube and failure of the eardrum to heal after the tube has fallen out. Rarely the tube can extrude inward into the middle ear or mastoid and therefore be retained. These complications may require additional procedures to rectify.