IIA12 - Myringotomy

Question 1

What is a myringotomy?

Answer 1

A surgical procedure where an incision/defect is made in the tympanic membrane to allow entry into the middle ear

Question 2

What are three purposes of performing a myringotomy?

Answer 2

1) To confirm the presence of fluid/ debris within the ear
2) To remove exudates from the ear for cytologic evaluation and culture
3) To drain the middle ear and apply topical therapy into the middle ear cavity

Question 3

What are the clinical indications for performing a myringotomy?

Answer 3

Clinical examination findings suggestive of otitis media or interna (hearing loss, vestibular signs, facial paralysis, etc) with either an abnormal tympanic membrane on otoscopic exam or abnormal middle/inner ear changes on diagnostic imaging

Question 4

Why is intubation important during myringotomy aside from the purpose of anesthesia?

Answer 4

The ET tube help prevent aspiration of fluid draining from the auditory (eustation) tube during the procedure

Question 5

In what quadrant of the tympanic membrane is the myringotomy incision made?

Answer 5

In the caudoventral quadrant

Question 6

What complications may arise after a myringotomy procedure?

Answer 6

Horner’s syndrome
Facial paresis or vestibular signs
Permanent defect in the tympanic membrane

Question 7

How long does it take for the tympanic membrane to heal after a myringotomy in a non-complicated case?

Answer 7

Typically about 1 month

Question 8

What is the most common cause of otitis media/interna in dogs and what are the two most common causes in cats?

Answer 8

Dogs - Chronic, recurrent otitis externs

Cats - nasopharyngeal polypse and upper respiratory infections