Paracentesis with / without tympanic drainage

Paracentesis (eardrum incision) is one of the most common operations in otorhinolaryngology.

It is a minor surgical procedure involving an incision of the eardrum to relieve pressure and effusion, which is used to restore middle ear ventilation, usually in the case of a blocked eustachian tube.

In addition, if indicated, a drainage tube (synonyms: tympanic tube; tympanic drainage) made of gold can be inserted. This usually remains in place for about 4-8 months and usually falls out again on its own.

This procedure may be necessary for the following diagnoses, among others:

• acute/recurrent otitis media (inflammation of the middle ear)
• Tympanic effusion resistant to therapy or persistent - accumulation of fluid or secretion in the middle ear, e.g. in the case of enlarged polyps (adenoids)
• Chronic tympanic membrane retraction (eardrum retraction)
• Gaping Eustachian tube - the connection between the nasopharynx and the middle ear is too wide open, allowing air to enter the middle ear
• Mastoiditis - inflammation of the aerated bone cells of the mastoid process
• transtympanic gentamicin treatment - antibiotic treatment for Meniere's disease (disease of the inner ear characterised by attacks of rotary vertigo, unilateral hearing loss and ringing in the ears)

Under microscopic vision, a small incision is made in the lower eardrum area. The secretion is sucked out of the tympanic cavity through this opening. If this secretion is viscous (sermucotympanum), then a drainage tube is inserted into the opening.

Which anaesthetic procedure is used?

In the child, the procedure is performed under anaesthesia.

What side effects are to be expected?

After the eardrum incision or tympanic drainage, some blood or fluid may drain from the ear canal for a short time. This is insignificant. Very rarely, there may be a slight earache or a feeling of pressure in the ear at first. As a rule, however, this procedure does not cause any pain.

Possible consequences and risks:

• a middle ear infection after an eardrum incision is extremely rare; it usually only needs to be treated with local antibiotic ear drops.
• An intolerance reaction with inflammatory symptoms and running ears after insertion of a drainage tube is a rare occurrence. Only in absolutely exceptional cases does the tube have to be actively removed again.
• a permanent eardrum defect is extremely rare.
• When swimming and bathing, as little water as possible should get into the ear canal, as this can lead to inflammation. Therefore, swimming protection should be worn.