RESEARCH STARTER

Myringotomy

Myringotomy is a surgical procedure commonly performed to alleviate pressure and pain in the ear caused by fluid accumulation in the middle ear, often due to infections or allergies. During the procedure, a specialist inserts small tubes into the middle ear to facilitate drainage and restore proper function. Local anesthesia is typically used, especially for children, to minimize discomfort. The underlying issue is often related to a blockage of the Eustachian tube, which connects the middle ear to the nasal cavity and regulates air pressure essential for hearing and balance.

Before opting for myringotomy, patients may undergo treatments such as antihistamines, decongestants, or steroids to reduce Eustachian tube swelling. Post-procedure, many patients experience immediate improvements in hearing, and antibiotics may be prescribed to prevent infection. It is important to follow postoperative care instructions, which include keeping water out of the ear and using earplugs during activities like swimming. Although some sounds may occur in the ear after surgery, these sensations are generally temporary. The myringotomy tubes usually fall out on their own within six to twelve months, and follow-up visits are often scheduled to monitor recovery.

Full Article

  • ANATOMY OR SYSTEM AFFECTED: Ears (tympanic cavity and tympanic membrane)

DEFINITION: The creation of an opening in the eardrum (tympanic membrane) to allow drainage of accumulated fluid in the middle ear

Indications and Procedures

Fluid can collect in the middle ear as a result of infection or allergy; this fluid consists of blood, pus, water, and debris. An ear, nose, and throat specialist may surgically insert small tubes into the middle ear to facilitate drainage. Usually, local anesthesia is administered for adults; if the patient is a young child, general anesthesia may be used.

This procedure, called myringotomy, is used to relieve pain caused by pressure and to prevent temporary or permanent hearing loss. Physiologically, the problem involves blockage of the Eustachian tube, a narrow canal that connects the middle ear to the back of the nasal cavity. This tube regulates air pressure in the middle-ear cavity, allowing the hearing mechanism to function properly and helping to maintain a sense of balance.

Before performing a myringotomy, medical treatment may involve the prescription of antihistamines, decongestants, and perhaps steroids, which usually reduce the swelling of the Eustachian tube and sometimes preclude a myringotomy. After the procedure, improvement in hearing is usually immediate, and the middle-ear infection should heal. Antibiotic eardrops may be prescribed; three or four drops should be placed in each ear twice a day for five days. In approximately six to twelve months, the myringotomy tube will be expelled into the outer ear canal automatically and can be removed by a physician. Treatment may include follow-up visits every two months.

Uses and Complications

Postoperatively, it is not unusual for the patient to experience a certain amount of pulsation, popping, clicking, and other sounds in the ear. It is important during the postoperative period to make certain that the patient does not get water in their ear, especially when the tube is in place. When washing the hair or face, cotton covered with petroleum jelly may be placed in the outer part of the ear. For long-term protection, earplugs may be used during showering, bathing, and swimming. Diving, deep swimming, and any other activities that may place pressure on the eardrum are not recommended.


Bibliography

American Medical Association. American Medical Association Family Medical Guide. 4th rev., John Wiley & Sons, 2004.

Bluestone, Charles D. Pediatric Otolaryngology. McGraw-Hill, 2013.

Canalis, Rinaldo, and Paul R. Lambert, editors. The Ear: Comprehensive Otology. Lippincott Williams & Wilkins, 2000.

"Ear Tube Insertion." Medline Plus, 26 Feb. 2024, medlineplus.gov/ency/article/003015.htm. Accessed 29 Aug. 2025.

Ferrari, Mario. PDxMD Ear, Nose, and Throat Disorders. PDxMD, 2003.

Johnson, Jonas T., et al., editors. Bailey's Head and Neck Surgery—Otolaryngology. Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013.

Kalcioglu, Mahmut Tayyar, et al. Otology Updates. Springer, 2024.

“Myringotomy.” Cleveland Clinic, 20 Nov. 2024, my.clevelandclinic.org/health/treatments/22875-myringotomy. Accessed 29 Aug. 2025.

"Myringotomy: Ear Tubes ." UVA Health, uvahealth.com/services/hearing-balance/myringotomy-ear-tubes. Accessed 29 Aug. 2025.

"Myringotomy: Treating Secretory Otitis Media ." MSD Manuals, www.msdmanuals.com/home/multimedia/table/myringotomy-treating-secretory-otitis-media. Accessed 29 Aug. 2025.

Pender, Daniel J. Practical Otology. J. B. Lippincott, 1992.

Reilly, Brian Kip. "Myringotomy ." Medscape, 9 Nov. 2021, emedicine.medscape.com/article/1890977-overview. Accessed 29 Aug. 2025.

Sataloff, Robert T., and Pamela C. Roehm. Hearing Loss. 5th ed., Taylor & Francis, 2024.

Turkington, Carol, and Allen E. Sussman. The Encyclopedia of Deafness and Hearing Disorders. Rev. 2nd ed., Facts On File, 2004.

Woolf, Alan D., et al., editors. The Children’s Hospital Guide to Your Child’s Health and Development. Perseus, 2002.

Full Article

  • ANATOMY OR SYSTEM AFFECTED: Ears (tympanic cavity and tympanic membrane)

DEFINITION: The creation of an opening in the eardrum (tympanic membrane) to allow drainage of accumulated fluid in the middle ear

Indications and Procedures

Fluid can collect in the middle ear as a result of infection or allergy; this fluid consists of blood, pus, water, and debris. An ear, nose, and throat specialist may surgically insert small tubes into the middle ear to facilitate drainage. Usually, local anesthesia is administered for adults; if the patient is a young child, general anesthesia may be used.

This procedure, called myringotomy, is used to relieve pain caused by pressure and to prevent temporary or permanent hearing loss. Physiologically, the problem involves blockage of the Eustachian tube, a narrow canal that connects the middle ear to the back of the nasal cavity. This tube regulates air pressure in the middle-ear cavity, allowing the hearing mechanism to function properly and helping to maintain a sense of balance.

Before performing a myringotomy, medical treatment may involve the prescription of antihistamines, decongestants, and perhaps steroids, which usually reduce the swelling of the Eustachian tube and sometimes preclude a myringotomy. After the procedure, improvement in hearing is usually immediate, and the middle-ear infection should heal. Antibiotic eardrops may be prescribed; three or four drops should be placed in each ear twice a day for five days. In approximately six to twelve months, the myringotomy tube will be expelled into the outer ear canal automatically and can be removed by a physician. Treatment may include follow-up visits every two months.

Uses and Complications

Postoperatively, it is not unusual for the patient to experience a certain amount of pulsation, popping, clicking, and other sounds in the ear. It is important during the postoperative period to make certain that the patient does not get water in their ear, especially when the tube is in place. When washing the hair or face, cotton covered with petroleum jelly may be placed in the outer part of the ear. For long-term protection, earplugs may be used during showering, bathing, and swimming. Diving, deep swimming, and any other activities that may place pressure on the eardrum are not recommended.


Bibliography

American Medical Association. American Medical Association Family Medical Guide. 4th rev., John Wiley & Sons, 2004.

Bluestone, Charles D. Pediatric Otolaryngology. McGraw-Hill, 2013.

Canalis, Rinaldo, and Paul R. Lambert, editors. The Ear: Comprehensive Otology. Lippincott Williams & Wilkins, 2000.

"Ear Tube Insertion." Medline Plus, 26 Feb. 2024, medlineplus.gov/ency/article/003015.htm. Accessed 29 Aug. 2025.

Ferrari, Mario. PDxMD Ear, Nose, and Throat Disorders. PDxMD, 2003.

Johnson, Jonas T., et al., editors. Bailey's Head and Neck Surgery—Otolaryngology. Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013.

Kalcioglu, Mahmut Tayyar, et al. Otology Updates. Springer, 2024.

“Myringotomy.” Cleveland Clinic, 20 Nov. 2024, my.clevelandclinic.org/health/treatments/22875-myringotomy. Accessed 29 Aug. 2025.

"Myringotomy: Ear Tubes ." UVA Health, uvahealth.com/services/hearing-balance/myringotomy-ear-tubes. Accessed 29 Aug. 2025.

"Myringotomy: Treating Secretory Otitis Media ." MSD Manuals, www.msdmanuals.com/home/multimedia/table/myringotomy-treating-secretory-otitis-media. Accessed 29 Aug. 2025.

Pender, Daniel J. Practical Otology. J. B. Lippincott, 1992.

Reilly, Brian Kip. "Myringotomy ." Medscape, 9 Nov. 2021, emedicine.medscape.com/article/1890977-overview. Accessed 29 Aug. 2025.

Sataloff, Robert T., and Pamela C. Roehm. Hearing Loss. 5th ed., Taylor & Francis, 2024.

Turkington, Carol, and Allen E. Sussman. The Encyclopedia of Deafness and Hearing Disorders. Rev. 2nd ed., Facts On File, 2004.

Woolf, Alan D., et al., editors. The Children’s Hospital Guide to Your Child’s Health and Development. Perseus, 2002.

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