Myringotomy
Indications:
Acute suppurative otitis media:
Severe earache with the bulging tympanic membrane.
Incomplete resolution with opaque drum and persistent conductive deafness.
Complications of acute otitis media,e.g.facialparalysis, labyrinthitis or meningitis with the bulging tympanic
membrane.
Serous otitis media.
Aero-otitis media (to drain fluid and “unlock” the eustachian tube).
Atelectatic ear (grommet is often inserted for long-term aeration).
Contraindication:
Suspected intratympanic glomus tumor.
Incisions:
-In acute suppurative otitis media, a circumferential incision is made in the posteroinferior quadrant of the tympanic
membrane, midway between the handle of malleus and tympanic annulus, avoiding injury to the incudostapedial joint.
-In serous otitis media, a small radial incision is given in the posteroinferior or anteroinferior quadrant and all the effusion
is sucked out.
Complications:
Injury to incudostapedial joint or stapes
Injury to jugular bulb with profuse bleeding,
if jugular bulb is high and floor of the middle ear dehiscent.
Middle ear infection.