69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia

Name of the Procedure:

Tympanostomy (requiring insertion of ventilating tube), also known as myringotomy with tube placement or ear tube surgery.

Summary

Tympanostomy is a surgical procedure in which a small tube is inserted into the eardrum to allow air to enter the middle ear. This helps prevent fluid accumulation and can alleviate chronic ear infections or other middle ear issues. The procedure is performed under general anesthesia.

Purpose

• To treat chronic ear infections (otitis media).
• To relieve persistent middle ear fluid (effusion).
• To prevent hearing loss associated with fluid in the middle ear.
• To restore normal ear drainage and function.

Indications

• Recurrent acute otitis media (more than three infections in six months or four in one year).
• Persistent fluid in the middle ear for more than three months.
• Hearing difficulties due to middle ear fluid.
• Eustachian tube dysfunction.

Preparation

• Patients are advised to fast for several hours before the procedure.
• Any regular medications should be discussed with the surgeon, as some may need to be paused.
• Preoperative evaluation may include a hearing test or tympanometry to assess fluid in the middle ear.

Procedure Description

1. The patient is administered general anesthesia to ensure they are asleep and pain-free.
2. A small incision (myringotomy) is made in the eardrum.
3. Any fluid present in the middle ear is carefully suctioned out.
4. A small, hollow tube (ventilating tube) is inserted into the incision.
5. The tube allows air to enter the middle ear and prevents further fluid buildup.
6. The procedure is usually quick and straightforward, taking about 15 minutes.

Duration

The procedure typically lasts around 15 minutes.

Setting

Tympanostomy is usually performed in a hospital or an outpatient surgical center.

Personnel

• ENT (Ear, Nose, and Throat) Surgeon or Otolaryngologist
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Minor risk of infection or bleeding.
• Possible blockage or extrusion of the tube.
• Scarring of the eardrum.
• Rare risk of permanent hole in the eardrum.
• Very rare risk of hearing loss or anesthesia-related complications.

Benefits

• Reduced frequency and severity of ear infections.
• Improved hearing.
• Better speech and language development in children.
• Generally immediate relief from ear pressure and fluid buildup.

Recovery

• Patients can usually go home the same day.
• Mild discomfort or drainage from the ear may occur temporarily.
• Keep the ear dry; avoid swimming without ear protection.
• Follow-up appointments are necessary to monitor tube placement and ear health.
• Tubes typically fall out on their own within 6-12 months; occasionally, removal is needed.

Alternatives

• Watchful waiting for mild cases.
• Antibiotic therapy for bacterial ear infections.
• Nasal steroids or antihistamines for associated allergies.

• Hearing aids or other auditory amplification devices for hearing loss.

  Patient Experience

• During the procedure, the patient is under general anesthesia and will not feel any pain.
• After the procedure, there might be mild discomfort or a feeling of fullness in the ear.
• Pain management can include over-the-counter pain medications.
• Follow specific care instructions to ensure optimal recovery and success of the procedure.