EDUCATION11 April 2026

Myringotomy

Duration

15-30 minutes

Downtime

24-48 hours

Insurance

Covered

Setting

Outpatient

Overview

Myringotomy is indicated when there is persistent fluid buildup in the middle ear, causing hearing impairment (muffled sounds, much like hearing underwater) and recurrent infections. Your doctor makes a small cut in the eardrum to let fluid exit the middle ear and relieve symptoms.

When to Consider Myringotomy

Chronic ear fluid: Persistent, thick fluid in the middle ear.

Recurrent acute ear infection: frequent infections that do not respond well to antibiotics.

Delayed speech and learning: in children, this can cause learning difficulties, emotional distress, physical impairment, and poor school performance.

Severe pain and complications: like dizziness.

Tube Insertion

Tube insertion is done with myringotomy when there is fluid buildup that has persisted for more than 3 months and when there is recurrent ear inflammation (3 episodes in the last 6 months or 4 episodes in the last 12 months with at least 1 episode in the last 6 months).

Is Tube Insertion Necessary?

Myringotomy alone can drain ear fluid quickly, but it’s usually only used for severe cases that need fast relief. The small opening it creates closes on its own within 2–3 days, so the fluid can return.

To keep fluid from building up again, doctors place ear tubes.
These tubes keep the opening open for 6–12 months, allowing long-term drainage and preventing the problem from coming back.

Benefits

In myringotomy alone, 81.9% of patients had hearing improvement compared to 91.6% in myringotomy with tube insertion.

The procedure can restore hearing back similar to how it was before

Common Misconception - Making a tear in my eardrum will affect my hearing ability.

There were no cases in which myringotomy caused hearing loss. In fact, hearing will improve immediately after the procedure. The benefits of tearing the eardrum and tube placement exceed the risks.

Procedure Types

Cold Knife

Less expensive
For all age groups

Best for: Chronic recurrent middle ear fluid.

The surgically-made tear stays open without tube for 2-3 days and it closes automatically after that. This technique involves minimal bleeding.

Laser/radiofrequency

More expensive
For adults

Best for: Acute cases where short-term drainage is required (2-3 weeks)

The surgically-made tear stays open without tube for 2-3 weeks. It involves no bleeding at all.

Risks

The complications following Myringotomy with tube insertion are usually mild and can be managed easily. These include:

Complication	Rate	How to treat?
Ear drainage lasting longer than 1-4 days	16% in the first 4 weeks And 26% in the overall tube placement period (6-12 months) (Kay et al., 2001)	Antibiotic ear drops.
Tube obstruction	6-12% of the cases. (Uppal et al., 2005)	Manual removal of the blockage or ear drops.
Granulation tissue (bumpy red tissue results from healing)	4% of the cases. (Kay et al., 2001)	Antibiotic-steroid eardrops.
Tube falling out earlier than expected	NA	Needs an assessment for new tube placement.
An eardrum rupture after tube falling out early.	1-6% of the cases. (Hellström et al., 2011)	Might require an eardrum repair (tympanoplasty)
Tube displacement into the middle ear	~0.5% of the cases. (Hajiioannou et al., 2009)	Surgically removed.

Anesthesia

General anesthesia:

Most commonly used for children. It is administered via mask because the operation time is short. The child will be fully asleep and won't feel anything.

Local anesthesia:

Most commonly used for adults. It numbs the area where the tear is made. Patients will be fully awake but won't feel any pain during the procedure.