Myringotomy and Grommet Insertion

Myringotomy and Grommet Insertion

Myringotomy is a surgical procedure that can be used to relieve pressure or drain fluid from the middle ear. Myringotomy may be performed to drain persistent fluid in the middle ear (glue ear) that is causing hearing loss or to treat Eustachian tube malfunction that is preventing natural ventilation of the middle ear when swallowing.

This procedure is usually performed by an ENT specialist under a topical local anaesthetic in adults, although in children a general anaesthetic is required. Local numbing injections, which cause a temporary mild stinging sensation, are not normally necessary. Instead, local anaethetic cream is applied directly and accurately to the surface of the ear drum using a special applicator, under direct vision using the operating microscope. The cream is left in place for about 30-45 minutes. During this time the patient can sit up, walk around, drink a cup of coffee or other beverage, and even leave the ENT clinic for refreshments outside. After half an hour or so the cream is sucked off the ear drum surface. A small nick is made in the eardrum in order to allow any fluid to be aspirated by micro suction. If there was hearing loss it is improved immediately. If left, this small incision would usually close within a few days. A small tube or grommet may be inserted into the eardrum during the myringotomy in order to keep the incision open for a longer period, typically between 2 and 12 months, to allow air to ventilate the middle ear and settle down. Grommets tend to block naturally and are then pushed out of the ear drum, which almost always heals up during this extrusion process. Grommets and “tubes” come in various sizes; some with t-extensions which stay in place much longer, often for several years.