When to puncture the eardrum?


Incision of the tympanic membrane is a procedure used to drain fluid or pus from the tympanic cavity. This technique is commonly used to treat otitis media with pus and otitis media.

1. Indications and contraindications for tympanic membrane puncture

1.1 Designation


Incision of the tympanic membrane to drain pus in the ear is indicated for the following cases:
Acute otitis media with pus or pus rupture. However, the hole is too small to drain the pus; Otitis media with effusion. This is a buildup of fluid (not an infection) in the middle ear. The discharge can be caused by a cold, sore throat, or an upper respiratory infection. This condition usually resolves on its own within 4-6 weeks. However, in some cases, the fluid can persist for a long time, causing temporary hearing loss. In some serious cases, fluid in the ear can even cause an infection.

1.2 Contraindications


Incision of the tympanic membrane is contraindicated in cases of suspected carotid tumor. Carotid tumor is a type of paraganglioma, located at the bifurcation of the common carotid artery. Gallbladder tumors are usually benign, slow-growing. However, it can spread through blood vessels to the floor of the skull and into the brain, causing compression complications, which can be fatal.

2. Incision procedure of the eardrum

2.1 Preparation


Personnel: Ear - nose - throat specialist; Technical means: Ear - nose - throat examination kits, eardrum incision knife; Patient: For adults and older children, sit with the affected ear facing the doctor. For young children, use a towel to wrap the baby tightly, one to hold the child and one to take care of the baby for the doctor to easily manipulate.
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2.2 Make an incision of the tympanic membrane


Use an antiseptic solution to clean the ear canal; The doctor's left hand places the otoscope, clearly identifying the position of the eardrum; The doctor's right hand holds an auricular knife to make an incision about 2-3mm long in the posterior 1⁄4 below the tympanic membrane along the margin, the position of the hammer handle and the tympanic membrane. Note that the tip of the knife only cuts the tympanic membrane, not going deep into the inner wall behind the tympanic cavity. When the incision is finished, if there is fluid or pus coming out, wipe or suck it clean; Place a tente (small piece of gauze folded on one end) impregnated with chloramphenicol antibiotic solution into the outer ear canal, the tip of the tente touching the tympanic membrane to drain fluid and pus, withdraw the tente after 24 hours. If there is still pus in the ear, another tente should be placed for better drainage.

2.3 Monitoring and handling of accidents


Incision of the eardrum in the wrong position can cause many complications such as: Injury to the bone, damage to the outer ear canal, damage to the round window. Depending on the case, the doctor will have appropriate treatment interventions.
Incision of the tympanic membrane is a relatively simple procedure, easy to perform. However, this technique still carries the risk of complications. Therefore, when patients are assigned to perform eardrum puncture, they should absolutely follow the doctor's instructions.
Vinmec International General Hospital is a general hospital that has the function of examining and treating ENT diseases such as sinusitis, rhinitis, allergic rhinitis, chronic rhinitis, tonsillitis, and pain. throat, tinnitus, otitis media and many other diseases. At Vinmec, we have also performed endoscopic diagnosis and treatment with modern medical methods for ear, nose and throat diseases, which not only brings high efficiency but also minimizes complications of recurrent disease. The great success is because Vinmec is always fully equipped with modern facilities, examination and treatment procedures are carried out by a team of experienced and qualified doctors that will bring about treatment results. optimal for customers.

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