Tympanostomy

Myringotomy
Intervention
ICD-9-CM	20.020.0120.09
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A myringotomy, sometimes called by other names, is a surgical procedure in which a tiny incision is created in the eardrum (tympanic membrane) to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. A tympanostomy tube is inserted into the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously in two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure.

Those requiring myringotomy usually have an obstructed or dysfunctional eustachian tube that is unable to perform drainage or ventilation in its usual fashion. Before the invention of antibiotics, myringotomy without tube placement was also used as a major treatment of severe acute otitis media (middle ear infection).

The words myringotomy, tympanotomy, tympanostomy, and tympanocentesis overlap in meaning. The first two are always synonymous, and the third is often used synonymously. The core idea with all of them is cutting a hole in the eardrum to allow fluid to pass through it. Sometimes a distinction is drawn between myringotomy/tympanotomy and tympanostomy, in parallel with the general distinction between an -otomy (cutting) and an (creating a stoma with some degree of permanence or semipermanence). In this distinction, only a tympanostomy involves tympanostomy tubes and creates a semipermanent stoma. This distinction in usage is not always made. The word tympanocentesis specifies that centesis (aspiration for sampling) is being done.

Etymologically, myringotomy (, from Latin myringa "eardrum", + ) and tympanotomy ( + ) both mean "eardrum cutting", and tympanostomy ( + means "making an eardrum stoma".

In 1649, Jean Riolan the Younger accidentally pierced a patient's ear drum while cleaning it with an ear spoon. Surprisingly, the patient's hearing improved. There are also reports from the 17th and 18th centuries describing separate experiments exploring the function of the ear drum. In particular, the animal experiments of Thomas Willis were expanded upon by Sir Astley Cooper, who presented two papers to the Royal Society in 1801 on his observations that myringotomy could improve hearing. First, he showed that two patients with perforations of both eardrums could hear perfectly well, despite conventional wisdom that this would result in deafness. Second, he demonstrated that deafness caused by obstruction of the Eustachian tube could be relieved by myringotomy, which equalized the pressure on each side of the tympanic membrane.

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