Paracentesis of the tympanic membrane: implications

The First stage of acute otitis media are treated by conservative methods, which usually leads to full recovery. But sometimes, when the accumulation of significant amounts of pus, there is a risk of perforation of the tympanic membrane. This condition manifested severe pains, insomnia, loss of appetite, growing symptoms of intoxication. In this case, it is necessary to resort to the method of paracentesis. The essence of such intervention consists in incision of the eardrum to improve drainage of pus.

Indications for procedure

The Paracentesis of the tympanic membrane is carried out in case if conservative therapy proved ineffective. Urgent surgical intervention may be necessary if you experience the following symptoms:

- not passing throbbing ear pain;
- bulging eardrum;
- hearing loss;
- increasing the number of pus.
- increased temperature;
nausea.

The Paracentesis of the tympanic membrane is carried out urgently if there are signs of irritation of the inner ear or brain damage, such as nausea, dizziness, sudden headaches, etc.

The method

Paracentesis (myringotomy, tympanotomy) – this is a small surgical operation, which is required if conservative treatments do not help. During the procedure the ear drum, make a small incision with microscalpels or a special needle that allows you to display the accumulated exudate.

The restoration of the integrity of the membrane occurs independently. At the same time carry out reorganization of the cavity of the middle ear. This is necessary in order to remove pathogens and clean the pus out of the way places.

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How to perform the procedure

This operation is introduced into medical practice in the NINETEENTH century and is still used to treat the inflammatory process. Before the procedure, you must pass tests of urine, blood, pass koagulogrammou.

Surgery is performed most often at 3-4 day from the beginning of the disease. The main symptoms that require paracentesis, – fever, severe shooting pain in the ear, bulging of the tympanic membrane.

Manipulation is carried out using spear-shaped needle, which incision the lower part of the membrane. The doctor makes the puncture so that the needle is passed through the entire thickness of the membrane. Paracentesis of the tympanic membrane may be incomplete, as inflammation leads to significant thickening. If necessary, the puncture insert a shunt, which facilitates the discharge of the accumulated exudate.

Methods of anesthesia

The Main question those who recommended paracentesis of the tympanic membrane, – is it painful? Indeed, the process is extremely painful, so doctors use several methods of anesthesia:

1. Provodnikovym. Anesthetic drug administered via injection to the area behind the ear, which reduces the sensitivity of nerve endings.

2. Application. Substance for pain relief applied directly to the membrane.

3. Common. Paracentesis of the tympanic membrane in children is performed with the use of this type of anesthesia, as a small child difficult still to keep my head during the procedure.

Rehabilitation

After a paracentesis of the tympanic membrane is necessary to observe rules of hygiene. At the end of the procedure in the auditory canal insert sterile dry turundas which should be changed regularly to prevent the spread of infection. First, do this 6-8 times, and after suppuration will decrease – 3-4 times a day. In order to accelerate the elimination of pus, after the operation, it is desirable to sleep on the side of the patient's ear.

The Wound and auditory cavity treated with antiseptic drugs. With a thick pus used lavage with warm solution rivanola, furatsilina hydrogen peroxide, after which the auditory canal dry cotton swab. The procedure can be performed one to two times a day. For washing use the rubber spray. Pulling the ear up and back, sending a stream of water without pressure on the posterior wall of the auditory meatus.

To quickly release the ear cavity from purulent accumulations used blowing. For this procedure uses a balloon Catheterization or catheter, with purulent accumulations from the tympanic cavity are pushed into the ear canal. Sometimes used Sigle funnel, through which the pus is sucked through the external auditory canal.

After surgery quickly improves the condition of the patient, weakened by pain, reduced temperature, reduced hearing. For healing membranes will need two to three weeks. To prevent scarring, it is recommended to use hydrocortisone. This substance promotes better healing of the incision formed on the surface of the scar will be small and will not affect the hearing acuity.

Consequences and forecast

Whenconducted properly, paracentesis of the tympanic membrane have no unpleasant consequences is not. If the procedure has been performed with violations, may occur the following complications:

• Partial drainage of pus. In this case, the disease may become chronic. In order to get rid of the remaining pus, apply physiotherapy and suctioning;
• Wound infection resulting from the use of unclean materials during the procedure or when the wrong care in the rehabilitation period. With this complication will need the use of broad-spectrum antibiotics;
• Hearing loss due to scarring large. Fortunately, such complications are rare.

In compliance With the doctor's forecast is mostly favorable. Should not refuse, if to solve your problem the doctor recommends paracentesis of the tympanic membrane. The consequences of spontaneous rupture of the membranes is much worse, because it can form large scars. But it is best not to delay treatment of otitis media, to not have to get rid of the pus by surgical methods.