Type of Surgery
Information
Last updated: 11/24/2009
The diagnosis of otitis media is based on the doctor's visual examination of the patient's ear and the patient's symptoms. Patients with otitis media complain of earache and usually have a fever, sometimes as high as 105°F (40.5°C). There may or...
may not be loss of hearing. Small children may have nausea and vomiting. When the doctor looks in the ear with an otoscope, the patient's eardrum will look swollen and may bulge outward. The doctor can evaluate the presence of fluid in the middle ear either by blowing air into the ear, known as insufflation, or by tympanometry, which is an indirect measurement of the mobility of the eardrum. If the eardrum has already ruptured, there may be a watery, bloody, or pus-streaked discharge.
Fluid removed from the ear can be taken to a laboratory for culture. The most common bacteria that cause otitis media are Pneumococcus, Haemophilus influenzae, and Moraxella catarrhalis. Some cases are caused by viruses, particularly respiratory syncytial virus (RSV).
A child scheduled for a myringotomy should not have food or water for four to six hours before anesthesia. Antibiotics are usually not needed.
If local anesthesia is used, a cream containing lidocaine and prilocaine is applied to the ear canal about 30 minutes before the myringotomy. If medical acupuncture is used for pain control, the acupuncture begins about 40 minutes before surgery and is continued during the procedure.
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It is not uncommon for fluid to accumulate behind the eardrum (tympanic membrane). In this animation, we see the surgery used to open the tympanic membrane (myringotomy) and the placement of a drainage tube. This procedure is known colloquially as a patient "getting tubes in his ears."
During a myringotomy, an incision is made into the ear drum, or tympanic membrane (B). The fluid in the ear canal is suctioned out (C), and a small tube is put in place to allow future drainage in the event of an infection (D). (Illustration by GGS Inc.)
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Myringotomy is a surgical procedure in which a small incision is made in the eardrum (the tympanic membrane), usually in both ears. The word comes from myringa, modern Latin for drum membrane, and tomē, Greek for cutting. It is also called myringocentesis, tympanotomy, tympanostomy, or paracentesis of the tympanic membrane. Fluid in the middle ear can be sucked out through the incision.
Ear tubes, or tympanostomy tubes, are small tubes, open at both ends, that are inserted into the incisions in the eardrums during myringotomy. They come in various shapes and sizes and are made of plastic, metal, or both. They are left in place until they fall out by themselves or until they are removed by a doctor.
Other Information
In 2000, children's risk of surgery increased from 17.9% in 1981 to 20.2% in 1998/99, while ENT surgery rates increased by 21% over the period.
From: NCBI
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