Otitis media surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Luke Rusowicz-Orazem, B.S.

Surgery to treat otitis media is primarily myringotomy with or without insertion of a tympanostomy tube. It consists of creating an incision inside the tympanic membrane to relieve pressure by draining effusive fluid or suppuration. It is indicated for recurrent cases of acute otitis media and chronic suppurative otitis media when non-surgical treatment therapies do not relieve symptoms. Insertion of a tympanostomy tube is indicated for otitis media cases of which there is eustachian tube dysfunction causing necessary tympanic membrane reparation, as well as for suppurative complications requiring additional draining. Otorrhea is a possible complication of myringotomy performed with a tympanostomy tube inserted.

• Myringotomy involves creating an incision inside the tympanic membrane to relieve pressure by draining effusive fluid or suppuration.^[1]
• It is indicated for recurrent cases of acute otitis media and chronic suppurative otitis media for the following presentations:^[2]
  • Persistent symptoms while undergoing microbial therapy.
  • Suppurative complications.
  • Severe ear pain requiring immediate relief.
  • Indication for diagnostic tympanocentesis.
• Myringotomy accompanied by the additional insertion of a tympanostomy tube is indicated by the following :
  • Eustachian tube dysfunction.
  • Suppurative complication requiring additional drainage via the tympanostomy tube.
  • Necessity to repair the tympanic membrane from eustachian tube dysfunction.
• Otorrhea is a possible complication of performing a myringotomy with a tympanostomy tube, affecting up to 17% of intubated ears.^[3]

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