What Is a Bilateral Myringotomy?

Jacquelyn Gilchrist

A bilateral myringotomy (BM-T) is a surgical procedure used to treat chronic middle ear infections. It is usually performed on children who cannot be successfully treated with medication, or those who suffer from complications due to frequent ear infections. During this surgery, the excess fluid in the ear canal is drained and small tubes are inserted to relieve the pressure. Many patients recover quickly from this surgery, and can resume normal activities in about 24 hours.

A heart rate monitor is used during bilateral myringotomy.
A heart rate monitor is used during bilateral myringotomy.

If the surgeon plans to use general anesthesia to render the patient unconscious, the patient must refrain from eating or drinking for a period of time. Parents or caregivers must provide the surgeon with the child's complete medical history and inform him of any medications or supplements the child takes. Immediately prior to the bilateral myringotomy procedure, a blood pressure cuff and a heart rate monitor will be placed for monitoring. Then, the anesthesia will be administered.

A bilateral murinotomy is a procedure sometimes used to treat chronic middle ear infections.
A bilateral murinotomy is a procedure sometimes used to treat chronic middle ear infections.

The entire bilateral myringotomy procedure generally takes no longer than 10 to 15 minutes. A small hole will be made in the eardrum so that the excess ear fluid can be suctioned out. The surgeon will then insert a tympanostomy tube, which is a small device made of metal or plastic. This tube serves to provide air circulation to allow for fluid drainage so that the ear infections do not return.

Patients will gradually wake up from the anesthesia in a recovery room. Their vital signs will be monitored closely before being discharged from the hospital on the same day as the surgery. Recovery from a bilateral myringotomy does not require a special diet, but most patients may feel comfortable with softer foods and plenty of clear fluids for the first day. The level of pain experienced should be low and may be addressed with an over-the-counter pain reliever. Many patients can resume normal activities the following day.

Caregivers should expect some drainage from the ears, which may be slightly bloody or have the appearance of pus. Should the drainage continue after 48 hours, they should immediately notify the surgeon. Ear drops will need to be administered, typically for about five days. As the ear drum heals from the bilateral myringotomy, the tympanostomy tube should naturally fall out of the ear, typically within six to 18 months. Those who still have the tube after two to three years may require an additional surgery to remove it.

Before the patient undergoes a bilateral myringotomy, caregivers should be aware of the warning signs of potential complications, which do not commonly occur with this surgery. The doctor should be notified immediately if the patient displays severe or persistent pain, problems breathing, or rashes. Rarely, the ears may expel bright red blood. Other symptoms can include a fever, nausea, and vomiting.

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