Bilateral Myringotomy and Tubes with Tonsillectomy and 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 a failure to improve hearing, it usually indicates an additional problem in the middle or inner ear which the doctor will explain.
Tonsillectomy & Adenoidectomy is the removal of tonsils and/or adenoids. It is one of the most frequently performed throat operations, especially in children. It has proven to be a safe and effective surgical method for resolving breathing obstruction, recurring throat infections and in the case of the adenoids, managing recurrent childhood ear disease. 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. There are also some risks associated with the removal of tonsils and/or adenoids. Postoperative bleeding occurs in about 1-2% of cases and this can happen at any time during the first 2 weeks following the surgery. Treatment of bleeding is typically watchful waiting, but sometimes it may require a visit to the operating room under general anesthesia to get it under control. In very rare cases, a blood transfusion may be given if the problem is severe or deemed life-threatening. Because of the risk of bleeding, children who have had a tonsillectomy should only be cared for by adults who clearly understand how to get the child to an Emergency Room in case of bleeding or other emergencies. For the 2 weeks after their surgery travel outside our area is strongly discouraged.
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 recommended, the patient may need to be admitted to the hospital for IV fluid replacement. Very rarely, temporary disturbances in the sense of taste or soreness on one side of the tongue may occur. Although anesthetic complications are always a risk, they are quite uncommon.