Myringotomy for Eustachian Tube Dysfunction

Indications and Contraindications

The American Academy of Otolaryngology-Head and Neck Surgery recommends myringotomy with tympanostomy tube insertion for chronic otitis media with effusion persisting for 3 months or longer with symptoms, in patients with documented otitis media with effusion 1, 4
The American Academy of Otolaryngology-Head and Neck Surgery indicates that myringotomy with tympanostomy tube insertion is also recommended for otitis media with effusion in at-risk children 2
Myringotomy alone is considered ineffective for chronic conditions because the incision closes within several days, according to the American Academy of Otolaryngology-Head and Neck Surgery 6

Anesthesia risks for myringotomy are estimated at 1:50,000 for ambulatory surgery 6
Potential complications of myringotomy include tympanic membrane perforation, with a rate of 2% with short-term tubes and 17% with long-term tubes, as well as other sequelae such as otorrhea, tympanosclerosis, and focal atrophy 6, 7

The American Academy of Otolaryngology-Head and Neck Surgery recommends confirming the presence or absence of middle ear effusion through pneumatic otoscopy and/or tympanometry before considering myringotomy 4
If middle ear effusion is present for ≥3 months with symptoms, myringotomy with tube placement may be indicated, according to the American Academy of Otolaryngology-Head and Neck Surgery 1, 4