Indications and Procedural Steps of Myringotomy and Myringoplasty

Introduction

Myringotomy and myringoplasty are common otological procedures performed to treat various middle ear conditions. Proper understanding of their indications and procedural steps is essential for ENT specialists.

Indications for Myringotomy

• Acute otitis media with effusion
• Chronic serous otitis media
• Recurrent ear infections
• Barotrauma-related middle ear dysfunction

Step-by-Step Procedure for Performing Myringotomy

Preparation

• Patient evaluation and consent
• Sterilization and preparation of surgical instruments
• Administration of local or general anesthesia

Procedure Execution

1. Positioning the patient under an operating microscope
2. Identifying the optimal site for the incision (usually in the pars tensa)
3. Creating a small incision using a myringotomy knife or laser
4. Draining fluid from the middle ear
5. Placement of tympanostomy tubes, if required

Myringoplasty: Procedure and Indications

Indications

• Persistent tympanic membrane perforation
• Conductive hearing loss due to perforation
• Recurrent otorrhea

Steps of Myringoplasty

1. Patient preparation and anesthesia
2. Harvesting a graft (tragal cartilage, fascia, or perichondrium)
3. Preparing the perforation margins
4. Placing the graft in position using underlay or overlay techniques
5. Securing the graft and stabilizing the tympanic membrane
6. Postoperative care and monitoring

Conclusion

Myringotomy and myringoplasty are critical ENT procedures that effectively manage middle ear conditions. Proper execution and post-operative care ensure optimal patient outcomes.