How is a myringotomy performed in the treatment of acute otitis media (AOM)?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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In this procedure, the tympanic membrane is incised with a knife, and the resulting opening allows a fluid-filled middle ear to drain to the ear canal and the exterior. Depending on the size of the hole and the method used to create it, the tympanic membrane usually returns to normal within days to a few weeks.

A number of instruments, from knives to lasers, are available to perform this task, but the basic principles remain constant. The hole design, established either by size, by the application of material to retard healing, or by the type of initial tissue damage, is the primary factor in controlling how long the perforation remains open, which, in turn, is determined by patient need.

The use of a carbon dioxide laser in myringotomy on children with AOM has been promoted widely and directly to the consumer by the manufacturers of these instruments; proponents claim to have ushered in a new treatment for AOM without the use of antimicrobials. This approach is undoubtedly a boon for the otolaryngologist who is less technically adept, but to date, it has yielded little or no change in efficacy over standard myringotomy.

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