Bilateral Myringotomy and Tubes with Adenoidectomy
Myringotomy, with or without tympanostomy tube placement, is a very common ear operation. It is extremely safe and effective at removing persistent fluid from the middle ears, preventing ear infections and restoring normal hearing while avoiding the long term damaging effects of chronic Eustachian Tube Dysfunction on the eardrum and hearing. Complications are minor and usually appear in the form of drainage from the ear(s), which may be treated with antibiotic ear drops. After the procedure the tympanostomy tube usually remains in place for several months, although it may be pushed out sooner. In some cases, tubes may remain in place for years. As long as there is a tube in the ear, care should be taken to avoid water contamination, especially bathwater, by the use of earplugs and/or a bathing cap when the head is submerged. Rarely, the tympanic membrane fails to heal after the tubes come out naturally or have been removed. In these instances, perforation may require surgical repair at a later date if it does not heal on its own. In some cases, particularly when there is a family history of chronic ear disease, tympanostomy tubes may need to be replaced after they come out or stop working properly. This is one reason we follow patients with tubes in the ear by seeing them in the office every 4-6 months and checking their hearing annually. Hearing improvement is usually immediate after the tubes are placed, allowing fluid to be removed from the ear. In the uncommon event where there is failure to improve hearing, it usually indicates an additional problem in the middle or inner ear which the doctor will explain.
An adenoidectomy, which involves the removal of adenoid tissue, is one of the most frequently performed throat operations. It has proven to be a safe and effective surgical method for resolving nasal breathing obstruction and managing recurrent childhood ear infections. Pain following surgery is usually reasonably controlled with over the counter medication. It is similar to the pain that is experienced with throat infections but can also be felt in the ears after surgery. Postoperative bleeding occurs in less than 1% of cases and can occur at any time during the first 2 weeks after surgery. Bleeding is typically brief and only rarely would require a visit to an operating room under general anesthesia. Because swallowing can be painful after surgery, there is a tendency for poor oral intake of fluids. If swallowing pain cannot be controlled with the pain medications prescribed, the patient may need to be admitted to the hospital for IV fluid replacement. Occasionally, disturbances in the sense of taste or soreness on one side of the tongue may occur. Although anesthetic complications are known to exist, they are quite rare.