What is the role of myringotomy and aspiration of effusion in the treatment of otitis media with effusion (OME)?

Updated: Apr 06, 2020
  • Author: Thomas S Higgins, Jr, MD, MSPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

This section will briefly review myringotomy and aspiration of effusion and myringotomy with pressure equalization tube (PET) insertion.

Myringotomy and aspiration of effusion

When performed alone without the placement of pressure equalization tubes, this procedure has proved disappointing in long-term follow-up in children. Gates and others have shown that when myringotomy is performed with placement of pressure equalization tubes, there was improvement hearing, duration of middle ear effusion (MEE), time to recurrence, and need for repeated procedures.

Myringotomy and aspiration may be more a reasonable treatment in adults who can undergo the procedure in the office. The benefit is that immediate improvement in hearing and symptoms of aural fullness and pressure are possible. The drawback is that the incision usually heals within 1 week, whereas the underlying problem of eustachian tube dysfunction takes longer to resolve (6 wk on average); therefore, recurrences are common.

Myringotomy and aspiration is useful to treat patients with moderate to severe hearing loss as they recover normal middle ear function. A 20-25 dB conductive hearing loss added to their underlying loss may render hearing aids or other coping devices or strategies inadequate.


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