What is a myringotomy

Eardrum incision (paracentesis)

Paracentesis is a minor surgical procedure that can be considered if the patient has ventilation problems in the middle ear or a tympanic effusion. In the case of paracentesis, the surgeon opens a small incision in the eardrum to restore ventilation to the middle ear. The accumulated fluid can be carefully sucked out of the tympanic cavity. In some cases, a ventilation tube is inserted into the eardrum during the procedure, for example if the secretion is very viscous and difficult to drain off, or if there has already been a retraction in the area of ​​the eardrum. Often the tonsils are removed during this procedure.

Paracentesis is considered due to the listed complaints / diseases:

  • Tympanic effusion: A tympanic effusion that lasts for more than twelve weeks.
  • Acute otitis media: An inflammatory secretion forms in the tympanic cavity, which in some cases obstructs the Eustachian tube (ear trumpet) and can cause an ear tympanic effusion. This in turn can lead to a tube ventilation disorder. If the effusion does not improve with decongestant nasal drops, other expectorant drugs or antibiotics, a paracentesis is performed.
  • Enlarged tonsils (adenoids): An overgrowth of the pharynx can obstruct the mouth of the Eustachian tube. The tympanic cavity would no longer be ventilated and a negative pressure would be created. Fluid collects in this way and the result is a tympanic effusion.
  • Labyrinthitis: A purulent inner ear infection can be the result of an otitis media. The affected person suffers from pressure on the ears, fever, severe dizziness, nausea and vomiting, as well as hearing loss. A tympanic effusion is also often present and this can be relieved with a paracentesis.
  • Menière's disease: People with this disease suffer from dizziness, hearing loss and tinnitus. There is also increased pressure in the inner ear and pressure regulation in the middle ear is significantly impaired. In addition to other therapies, making an incision in the eardrum can help alleviate the discomfort.

In children, paracentesis is done under general anesthesia, but in adults it can be done with a local anesthetic alone. Paracentesis only takes a few minutes. The attending physician guides the scalpel or electrocautery through the external auditory canal to the eardrum and makes a 1-3 mm long incision in the eardrum under a microscopic view. Now the secretion is sucked off with a special suction device. The cut then heals on its own after about two weeks.

Ventilation tubes: If the secretion is very thick and cannot be suctioned off, or if the tympanic effusion keeps coming back, a so-called ear tube is inserted into the eardrum. As a result, the incision in the eardrum remains open for a longer period of time and the secretion can drain off completely. This ensures that the middle ear is ventilated again.

Healing time after an eardrum incision

The healing time after an eardrum incision is usually only a few days to a week. Since the incision is only one to three millimeters long, the eardrum tends to close and heal in a short time. If a ventilation tube was inserted during paracentesis, healing may take a little longer. Most of the time, the eardrum itself sheds the tubes after a few weeks or months and then falls out of the ear canal unnoticed.

The ear is still closed despite the eardrum cut

If the ear is still closed after an eardrum incision, a ventilation tube may need to be inserted. If fluid collects directly behind the eardrum, inserting the tube can ensure that the secretion can drain off regularly and completely and that the middle ear is again generously ventilated.

What to look for after an eardrum incision?

After a paracentesis has been performed, the following things should be observed:

  • Avoid water: As long as the ventilation tube is in the eardrum, avoid water flowing into the ear. When showering, bathing or swimming, special earplugs can be worn for swimming.
  • Allow yourself some rest: In the first few days after the procedure, you should rest enough and take it easy.
  • After general anesthesia: The patient should not be left alone for the next 24 hours so that any side effects can be treated directly.
  • Check-up appointment: A few days after the procedure, the attending physician will check whether the eardrum has healed well and will initiate follow-up treatment if necessary. With a hearing test, the doctor can then check whether your hearing is working properly again.