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Myringotomy and Ear Tube Insertion
Myringotomy (incision in the eardrum, tympanic membrane) with or without tube insertion is the most commonly performed ear operation. It is extremely safe and effective. The procedure is indicated for treatment of acute or recurrent otitis media (ear infection) or hearing loss due to fluid. The tube which usually remains in place for several months, may be rejected sooner or remain in place for years. As long as there is a tube in the ear, care should be taken to avoid water contamination by the use of earplugs or, if desired, a bathing cap. Hearing improvement is usually immediate after fluid has been removed from the ear. Failure to improve hearing indicates a second problem in the middle or inner ear.
Prior to surgery, drainage from behind the eardrum would build up causing infections, usually in the middle of the night. Following surgery the fluid will drain out. The prescription given to you at your preoperative visit will be used postoperatively, and if there is an ear drainage in the future. Occasionally tubes move internally and cause bleeding. Drops are also instituted at that time. The frequency of oral antibiotic usage should drop off significantly following tube placement. The tubes do not cause discomfort and eventually fall out on their own within 2 years. Tylenol® or Advil® can be used the first 24 hours if necessary for pain. If there is infection or thick fluid at the time of the procedure, ear drops (Ciprodex®) can be used for 3 days to treat this.
Procedure
When you arrive at the procedure center, an anesthesiologist will see you. There is no breathing tube, no needles, and no blood work required. The procedure is brief (approximately fifteen minutes). Dr. Coniglio will talk to you before and following the procedure.
Risks
Complications are minor, usually in the form of infection, which may be treated with antibiotics. Occasionally the tympanic membrane fails to heal after tubes have been removed. The resulting perforation may require surgical repair. In some cases, particularly when there is a family history of chronic ear disease, tympanostomy tubes may need to be replaced. As with any procedure requiring anesthesia, complications are known to exist. These complications are quite uncommon since patients are usually young and healthy.
Pre-Operative Instructions
Clear liquids may be given up to one hour prior to your departure for the procedure center. Otherwise, nothing to eat after midnight the evening before the procedure. This includes all liquids that are not clear (see through), food, candy, mints or gum. You may brush your teeth. Your procedure will be cancelled if you do not follow these instructions.
- Notify us of all routine medications and significant health history. If your child is on any medication that affects bleeding, please notify the office immediately.
- One hour prior to departure for the procedure center please give your child a dose of ibuprofen (the recommended dose per package instructions).
- At your preoperative appointment you will be given prescriptions for an antibiotic ear drop, Ciprodex®. This along with Tylenol® will be used following surgery. Please fill these prescriptions before your surgery so you will have them ready for use when you return home after surgery has been completed.
- Please call Westfall Surgery Center at 256-3862 before noon on the day prior to the procedure to confirm your arrival time.
Post-Operative Instructions
Activity
Your child may resume all activities immediately after surgery. As long as there is a tube in the ear, care should be taken to avoid water contamination by the use of earplugs or a bathing cap. Bath water is less of a problem, however. If there is any concern or contamination, just use the ear drops for a day or two.
Diet
Encourage your child to drink fluids and to advance to a regular diet as tolerated.
Medications
For any discomfort, your child may use Tylenol®. Follow package directions for dosage.
Instill three Ciprodex® ear drops in each ear twice a day for three days following surgery.
Keep the unused portion of Ciprodex® for future use. If your child develops an ear infection at a later date you may notice drainage of fluid or blood in the child's ear. If this happens, call the office and we will give you instructions. The ear infection is usually not painful for the child and does not constitute an emergency that cannot wait until office hours.
Wound Care
Fluid or bleeding from the ear following surgery is normal. If drainage is excessive place a small amount of cotton in the ear. A small piece of cotton covered with a thin layer of Vaseline® or earplugs in the ear canal during bathing or showering can also be used for ear protection.
Special Instructions
Please call the office if you notice fever above 102°, persistent bleeding or drainage, or pain unrelieved by measures described above.
Appointments
Please schedule a follow-up appointment four weeks after surgery: Subsequent appointments will be every four months for tube placement check.
For an emergency please call our professional answering service at 585-258-4840.
Please notify the office 585-256-3550 for any concerns. We are here to help in any way we can.
Dr. John U. Coniglio and Staff
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