Indications and Procedural Steps of Myringotomy and Myringoplasty

Indications for Myringotomy

Myringotomy is a surgical procedure performed to relieve pressure and drain fluid from the middle ear. It is indicated in cases of:

• Chronic otitis media with effusion (OME)
• Acute otitis media with severe pain and hearing loss
• Recurrent ear infections
• Barotrauma-induced middle ear effusion
• Conductive hearing impairment due to persistent fluid accumulation

Procedural Steps

Myringotomy

The myringotomy procedure involves:

1. Administering local or general anesthesia
2. Creating a small incision in the tympanic membrane using a myringotomy knife
3. Aspirating fluid from the middle ear
4. Placement of a tympanostomy tube if necessary to facilitate continuous drainage
5. Ensuring proper healing of the tympanic membrane

Myringoplasty

Myringoplasty, or tympanic membrane repair, involves the following steps:

1. Assessing the perforation size and location
2. Harvesting an autologous graft (e.g., tragal perichondrium or temporalis fascia)
3. Preparing the graft and placing it over the perforation site
4. Securing the graft with gel foam or fibrin glue
5. Ensuring proper healing and postoperative care