ISSN 2398-2950      

Myringotomy

ffelis
Contributor(s):

Lynette Cole

Laura Owen


Introduction

  • Intentional puncture of the tympanic membrane to allow access to the middle ear.
  • The normal tympanum is translucent, shiny and concave in appearance.

Uses

  • Diagnosis of otitis media.
  • Sample collection from the tympanic bulla for cytology, bacteriology or histopathology.
  • Flushing of the middle ear to remove inflammatory or infected material.
  • May improve drainage of exudate from the middle ear.
  • Temporary relief of pressure within the middle ear of animals with otitis media Otitis media.

Advantages

  • Minimally invasive procedure.
  • Easy to perform (with appropriate instruction/training).
  • No special equipment required (other than hand-held otoscope).
  • Can be both diagnostic (visualization of bulla contents and collection of samples for laboratory analysis) and therapeutic (flushing of bulla to remove infected/inflammatory material).

Disadvantages

  • Can be associated with complications, some severe.
  • Visualization of tympanic bulla is limited to that seen through the small myringotomy incision.
  • Advanced imaging may provide more detail on disease involvement of the middle ear, eg expansion of bulla or destruction of bone.
  • As the cat has a bony septum that divides the middle ear space into two distinct cavities, connected only by a narrow opening (foramen), it is not possible to completely flush the bullar cavity (the ventral-medial cavity) when doing a myringotomy and flush.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Tympanic membrane should heal well within 21-35 days if infection and inflammation is controlled.
  • Prognosis for otitis externa/media is dependent upon severity of disease and underlying cause.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Griffin C E (2006) Otitis techniques to improve practice. Clin Tech Small Anim Pract 21 (3), 96-105 PubMed.

Other sources of information

  • Cole L K (2004) Otoscopic evaluation of the ear canal. Vet Clin North Am Small Anim Pract 34 (2), 397-410 PubMed.
  • Cook L B (2004) Neurologic evaluation of the ear. Vet Clin North Am Small Anim Pract 34 (2), 425-435 PubMed.
  • Gortel K (2004) Otic flushing. Vet Clin North Am Small Anim Pract 34 (2), 557-565 PubMed.
  • White R A S (2003) Middle ear. In: Textbook of Small Animal Surgery. ed Slatter. pp 1757-1759.

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