Instructions for Myringtomy and Tubes

EAR: The normal middle ear is filled with air. This is necessary for the general good health of the ear and for the mechanism itself to work properly. The air pressure in the middle ear should be equal to the air pressure on the outer side of the eardrum. The Eustachian tube, which connects the middle ear to the back of the throat, helps to maintain the balance of air pressure. When the adenoids or surrounding lymph tissue become enlarged due to respiratory infection, nasal allergy, or other causes, the Eustachian tube will close, blocking the healthy exchange of air. As a result a vacuum will develop in the middle ear cavity causing accumulation of fluid. This condition is called serous otitis media. This is the most common cause of hearing loss in children and may be the source of recurrent ear pain and/or drainage if infection occurs. Early signs include hearing loss, daydreaming, poor sleep, pulling at ears, pain, drainage, or poor eating habits. Antihistamines or nasal steroids for allergic problems, oral decongestants, antibiotics, and steroids are usually used initially to treat this problem Should this condition become chronic or recurrent, myringtomy with tubes may be necessary.

MYRINGOTOMY: The procedure consists of making a small incision in the eardrum under high power magnification. The fluid in the middle ear cavity is then removed with suction. Tiny plastic tubes are then inserted through the tympanic membrane so as to keep the myringotomy incision open for a period of time to allow drainage and aeration of the middle ear space. These tubes help to function like a temporary Eustachian tube until the normal Eustachian tube is healed and working properly again. Sometimes ear drops are placed in the ear at the time of surgery and continued for a few days postoperatively. If an adenoidectomy is done, this usually consists of removing the adenoids through the mouth, as they lie behind the soft palate and uvula. A small electric probe may be used to cauterize or melt the adenoid tissue. Bleeding with this procedure is minimal.

If your child has a favorite toy, blanket or pacifier please feel free to bring it with you.

If your child has a special cup or bottle they like to drink from or a special formula, please bring it with you the day of surgery.

Your child may be placed on oral antibiotics for 3-5 days after surgery.

Tylenol products should be available for use after surgery should your child require any medication for pain and/or fever. Avoid the use of Advil, Motrin and Aspirin products.

Your child may also be placed on ear drops after surgery. Here are some instructions that will help you successfully instill these ear drops:

• Warm ear drops prior to use.
• Wash hands and explain procedure to patient.
• Instruct patient to turn head with affected ear in upward
  position.
• Straighten ear canal by holding ear upward and
  backward.
• Instill medication as ordered by physician.
• Instruct patient to remain in position with affected ear
  upward for about 5 minutes.

After surgery encourage your child to drink fluids to keep well hydrated.

Your child may be irritable after surgery. He or she may be restless and crying. This reaction is normal. The behavior will subside in 1-2 hours after discharge.

Keep water out of ears. You may choose to use Mack’s Ear Plugs, available at most drug stores, or cotton balls coated with Vaseline. Custom fitted plugs are available at Dr. John Simpson’s office.