Indications for tympanic membrane catheterization

The article was consulted with Specialist Doctor I Tran Minh Tuan - Doctor of Ear, Nose and Throat - Head and Neck Surgery - Department of General Surgery - Vinmec Nha Trang International General Hospital.

There are many ear problems such as eustachian tube dysfunction, ear infections that greatly affect the ability to hear and speak. The procedure of tympanic membrane catheterization is currently one of the best methods today to help restore the ability to hear and speak in people with ear infections.

A tympanic membrane catheterization is a procedure that inserts a small tube (hard plastic or silicone tube) into the eardrum, creating an air passage between the outer ear and the middle ear and preventing fluid from pooling behind the eardrum.

Continuous otitis media with seroma, lasting more than 3 months, unresponsive to medical treatments Enlarged VA causes otitis media with seroma

Intubation of the tympanic membrane will help restore ventilation and drainage of the ear. The catheter helps to balance the pressure between the middle ear and the outer ear canal. Helps reduce the risk of ear infections , because the ventilation tube will help prevent fluid / pus from pooling behind the eardrum. Restore or help partially improve hearing. Improve speaking ability. The time to perform 1 case of tympanic membrane ventilation is short, if one side is 30 minutes, both sides are 60 minutes, so it doesn't take much of your time. 1-2 hours after the tympanic membrane catheter is in place, you can go home right away.

Steps to take:
For children needing anesthesia, adults can have local anesthesia. Disinfect the ear canal and eardrum. Incision of the tympanic membrane (anterior inferior angle). Vacuum the ear canal through the vent. Place the ventilation tube through the puncture hole. Place a tente impregnated with antiseptic into the ear canal. Follow-up and care after tympanic membrane catheterization surgery:
Careful monitoring is required in the first week to check the condition of the ventilation tube, if there is a lot of fluid, it should be drained. The cannula may be placed in the ear for 6 months to 1 year. During the placement of the tympanic membrane tube, it is important to avoid getting water into the ear. Extubation of the tympanic membrane requires a hearing test and a catheterization test. Complications and treatment:
Intubation of the tympanic membrane: Need to reset through the above steps. If the cannula slips into the ear canal, the tympanic membrane needs to be released to remove it. Receptive Deafness: Usually caused by a rough and incorrect incision. Dislocation of the shinbone: Replacing surgery is required. Ear infection after tympanic membrane catheterization: The tube placement is not seamless, causing eardrum perforation, requiring systemic antibiotics and ear medication. Tympanic tube obstruction: Needs to be examined under a microscope, aspirate and clear the blockage from the catheter. Ear cholesteatoma (rare).

Steps to take:
For children who need anesthesia, adults can have local anesthesia. Insert the endoscope into the ear canal, then align the endoscope so that the eardrum is in the right direction and in the center of the screen. Anesthesia of the ear canal: Anesthesia is administered subcutaneously so that the skin on the floor of the ear canal to the edge of the eardrum turns white but does not blister. Incision of the tympanic membrane at the anterior lower angle with a crescent knife, the length of the incision is from 1.5 to 2 mm depending on the type of ventilation tube. Place the tympanic membrane catheter through the incision in a button-down fashion with microsurgical forceps or with a sharp rod. Follow-up after endoscopic tympanic membrane catheterization
Monitor systemic and local conditions due to possible anesthetic allergy. Complications and management:
Intraoperative complications: Bleeding: Immediately need to aspirate, put 0.1% adrenaline cotton, wait for about 10 minutes, if bleeding stops, surgery can be continued. Postoperative complications: Intubation: If there is still fluid checked, it should be reinserted. Obstruction of the airway: Perform endoscopic aspiration to clear the obstruction. Purulent otitis media: The cause is due to inadequate aseptic suture at the time of tube insertion, or acute nasopharyngitis or allergy to the airway. For this case, it is necessary to treat by making ear drops and topical drops and treating the cause. Late complications: Receptive deafness: This complication is rare, and the cause is currently unknown. Postoperative cholesteatoma is due to the involution of the tympanic membrane. The treatment of this complication is to remove the tube, open the tympanic cavity to remove the lesions and patch the atrium.

You should have your ears checked regularly after an eardrum catheter is placed. At that time, the doctor will check to see if the ventilation tube is really working properly, and your hearing has improved.
When there is a ventilation tube in the ear, it is necessary to avoid getting water in the ear when bathing or swimming. Because water entering the ear is very susceptible to infection with pathogens that cause ear infections.

The tympanic membrane tube will usually fall out on its own after 6 to 18 months. If the catheter does not fall off on its own, you will need a surgeon to remove the catheter. After the catheter has been removed from the ear, you will still need to monitor whether the ear is inflamed again, and if there is any fluid/pus behind the eardrum.
Intubation of the tympanic membrane is an interventional surgery in the tympanic membrane to ensure ventilation and drainage of the fluid in the ear cavity, in cases where there is a dysfunction of the tympanic membrane. This surgery is only considered a temporary solution, you need to coordinate with measures to treat the cause to solve your condition.
Currently, the ENT specialist - Vinmec International General Hospital is one of the prestigious addresses, trusted by a large number of customers in examining and treating common ENT diseases, tumors. head, face, neck, congenital malformations in the ENT region by common surgical methods such as surgery, microscopic or endoscopic tympanic patch, fistula removal, Bondy surgery, nasopharyngeal aerosol, injection Not only has a system of modern facilities and equipment, Vinmec is also a place to gather a team of experienced doctors and nurses who will greatly assist in the diagnosis. diagnose and detect early signs of abnormality of the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec guarantees to bring patients the most comfort, friendliness and peace of mind during the examination and treatment at the Hospital.