تعريف

A myringotomy is a procedure to put a hole in the ear drum. This is done so that fluid trapped in the middle ear can drain out. The fluid may be blood, pus, and/or water. In many cases, a small tube is inserted into the hole in the ear drum. The tube helps to maintain drainage. This surgery is most often done on children, but is sometimes done on adults.

أسباب هذا الإجراء

A myringotomy may be done:

  • To help treat an ear infection that is not responding to medical treatment
  • To restore hearing loss caused by fluid build-up and to prevent delayed speech development caused by hearing loss in children
  • To take sample fluid from the middle ear to examine in the lab for the presence of bacteria or other infections
  • To place tympanostomy tubes—These tubes help to equalize pressure. It may also help prevent recurrent ear infections and the accumulation of fluid behind the ear drum.

After the procedure, pain and/or pressure in the ear due to fluid build-up should be alleviated. Hearing loss due to fluid build-up should improve as well.

المضاعفات المحتملة

Complications are rare, but no procedure is completely free of risk. If you are planning to have a myringotomy, your doctor will review a list of possible complications, which may include:

  • نزيف
  • العدوى
  • Failure of the myringotomy incision in the ear drum to heal as expected
  • فقدان السمع
  • Injury to ear structures other than the ear drum
  • الحاجة لتكرار الجراحة

ما يمكن توقعه

قبل الإجراء

طبيبك سوف المرجح أن تفعل ما يلي:

  • تحاليل الدم
  • Hearing test
  • Tympanogram—a test that measures how well the ear drum responds to changes in pressure
  • Examine the external ear and the ear drum with a special instrument called an otoscope

المؤدية إلى الإجراء الخاص بك:

  • للترتيب من الإجراء.
  • Do not eat or drink anything for at least eight hours before the procedure.

التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:

  • الأسبرين أو غيره من العقاقير المضادة للالتهابات
  • سيولة الدم, مثل كلوبيدوجريل (بلافيكس) أو الوارفارين (الكومادين)

التخدير

General anesthesia is most often used. You will be asleep. In some cases, a local anesthetic will be used to numb the ear.

الوصف الداخلي

A small microscope is placed in position to give the doctor a better view. A tiny incision will be made in the eardrum. Fluid from the middle ear will then be drained. In most cases, a small tube will be inserted and left in place. This will allow the drainage to continue.

No stitches will be used to close the incision. The incision will heal itself. The procedure is often done on both ears. Some doctors may use a laser beam to make the opening in the ear drum.

بضع الطبلة

كم من الوقت سيستغرق ؟

The surgery will last about 15–20 minutes.

هل سيكون هناك ألم؟

Anesthesia prevents pain during surgery. You may have minor pain after surgery. Your doctor can give you pain medicine or recommend a nonprescription pain reliever to manage this discomfort. Also, lidocaine ear drops may be given 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.

الرعاية ما بعد الجراحة

After the procedure, be sure to follow your doctor’s instructions , which may include:

  • If cotton was placed in the ear canal to absorb postsurgical drainage, change it regularly. (Drainage should end or reduce to a minimal amount within 2-3 days.)
  • If you are given ear drops, use as directed. You will usually put three drops in each ear, three times a day for three days after surgery.
  • If water gets in the ear after surgery, monitor for drainage. If drainage begins, use ear drops if directed by your physician, and if drainage continues for three days (or as directed), call your doctor.
  • To speed healing, resume normal activities as soon as possible.
  • Take any medicines as prescribed by your doctor.
  • Use ear plugs as 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 ear drops, cotton, or ear plugs into the ear, unless instructed otherwise by your doctor.
  • اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.

Complete healing without complications should occur within four weeks. 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.

استدعاء الطبيب

بعد وصوله الى المنزل ، اتصل بطبيبك إذا كان أي من الحالات التالية:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the ear
  • ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
  • Drainage from ear continues for more than four days after surgery
  • Decreased hearing
  • سعال ، ضيق تنفس ، ألم في الصدر ، غثيان أو قيء شديد
  • Any other new concerns

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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