Otitis media surgery: Difference between revisions

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==Overview==
Surgery to treat otitis media is primarily [[myringotomy]] with or without insertion of a [[tympanostomy tube]]. It consists of creating an incision inside the [[tympanic membrane]] to relieve pressure by draining effusive fluid or [[suppuration]]. It is indicated for recurrent cases of acute otitis media and chronic [[suppurative]] otitis media when non-surgical treatment therapies do not relieve symptoms. Insertion of a tympanostomy tube is indicated for otitis media cases of which there is [[eustachian tube]] dysfunction causing necessary [[tympanic membrane]] reparation, as well as for [[suppurative]] complications requiring additional draining. [[Otorrhea]] is a possible complication of [[myringotomy]] performed with a tympanostomy tube inserted.
==Surgery==
==Surgery==
===Acute Otitis Media===
===[[Myringotomy]]===
Prior to the invention of [[antibiotics]], severe acute otits media was mainly remedied surgically by [[Myringotomy]].  An outpatient procedure, it consists of making a small incision in the [[tympanic membrane]] to relieve pressure build-up.
*[[Myringotomy]] involves creating an incision inside the [[tympanic membrane]] to relieve pressure by draining effusive fluid or [[suppuration]].<ref name="urlEar tube insertion: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/003015.htm |title=Ear tube insertion: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
===Chronic Otitis Media with Effusion===
*It is indicated for recurrent cases of acute otitis media and chronic [[suppurative]] otitis media for the following presentations:<ref name="pmid6540871">{{cite journal |vauthors=Bluestone CD |title=Surgical management of otitis media |journal=Pediatr Infect Dis |volume=3 |issue=4 |pages=392–6 |year=1984 |pmid=6540871 |doi= |url=}}</ref>
In chronic cases or with effusions present for months, surgery is sometimes performed by an otolaryngologist (ear, nose, and throat specialist) or by an otologist (ear specialist), to insert a [[grommet]] (called a "[[tympanostomy tube]]") into the [[eardrum]] to allow air to pass through into the [[middle ear]], and thus release any pressure buildup and help clear excess fluid within.
**Persistent symptoms while undergoing [[microbial]] therapy.
 
**[[Suppurative]] complications.
**Severe [[ear pain]] requiring immediate relief.
**Indication for diagnostic [[tympanocentesis]].
*[[Myringotomy]] accompanied by the additional insertion of a [[tympanostomy tube]] is indicated by the following :
**[[Eustachian tube]] dysfunction.
**[[Suppurative]] complication requiring additional drainage via the tympanostomy tube.
**Necessity to repair the [[tympanic membrane]] from [[eustachian tube]] dysfunction.
*[[Otorrhea]] is a possible complication of performing a [[myringotomy]] with a tympanostomy tube, affecting up to 17% of intubated ears.<ref name="pmid18697973">{{cite journal |vauthors=Schmelzle J, Birtwhistle RV, Tan AK |title=Acute otitis media in children with tympanostomy tubes |journal=Can Fam Physician |volume=54 |issue=8 |pages=1123–7 |year=2008 |pmid=18697973 |pmc=2515237 |doi= |url=}}</ref>
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Otolaryngology]]
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Latest revision as of 23:30, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Luke Rusowicz-Orazem, B.S.

Overview

Surgery to treat otitis media is primarily myringotomy with or without insertion of a tympanostomy tube. It consists of creating an incision inside the tympanic membrane to relieve pressure by draining effusive fluid or suppuration. It is indicated for recurrent cases of acute otitis media and chronic suppurative otitis media when non-surgical treatment therapies do not relieve symptoms. Insertion of a tympanostomy tube is indicated for otitis media cases of which there is eustachian tube dysfunction causing necessary tympanic membrane reparation, as well as for suppurative complications requiring additional draining. Otorrhea is a possible complication of myringotomy performed with a tympanostomy tube inserted.

Surgery

Myringotomy

References

  1. "Ear tube insertion: MedlinePlus Medical Encyclopedia".
  2. Bluestone CD (1984). "Surgical management of otitis media". Pediatr Infect Dis. 3 (4): 392–6. PMID 6540871.
  3. Schmelzle J, Birtwhistle RV, Tan AK (2008). "Acute otitis media in children with tympanostomy tubes". Can Fam Physician. 54 (8): 1123–7. PMC 2515237. PMID 18697973.

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