What are possible surgical complications 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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Answer

Complications of tympanocentesis and myringotomy are few and rare in appropriately performed procedures in children with otherwise normal anatomy. They include the following:

  • Immediate complications - Injury to the skin of the ear canal; injury to the ossicular chain

  • Intermediate complications - Persistent otorrhea; persistent perforation; external otitis from persistent drainage; implantation cholesteatoma

  • Long-term complications - Persistent perforation, with or without otorrhea; ear canal stenosis

The complications for myringotomy with ventilation tube placement are the same, with the addition of those related to the tube and to longer perforation.

With tubes of modern design, medialization is now quite rare. Some tube designs have a tendency to collect epithelial debris and inherently have a higher rate of cholesteatoma formation. As a rule, longer ventilation increases the likelihood of persistence of the perforation, the formation of aural polyps, and chronic otorrhea. Most of these complications are reversed by removal of the tube, with or without repair of the hole with a small myringoplasty.


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