Paracentesis (myringotomy): quick relief of the ear from fluid and pain

Severe ear pain, hearing loss, a sensation of “fluid sloshing” inside, and high fever are classic signs of middle ear inflammation (otitis). When exudate (fluid) or pus accumulates behind the eardrum, it begins to put strong pressure on the tissues, causing unbearable suffering. If drops and antibiotics do not relieve this pressure, ENT doctors at St. Luke’s Clinic prescribe paracentesis (myringotomy).

This is a safe, vital microsurgical procedure during which the doctor makes a tiny incision in the eardrum to release the fluid. This manipulation brings the patient immediate relief and saves them from dangerous complications.

Why should myringotomy be done on time?

Many parents and adult patients are panically afraid of the word “puncture”, believing that it will lead to deafness. In fact, hearing loss is provoked precisely by refusing the procedure!

If pus or thick fluid remains in the middle ear for a long time, it can “melt” the auditory ossicles, spread to the skull bone (mastoiditis), or even to the brain. In addition, if the eardrum ruptures on its own (under pus pressure), a large ragged wound will form. It heals very slowly and leaves a rough scar that permanently impairs hearing. Myringotomy is a controlled micro-incision (1-2 mm) that heals without a trace in just a few days, fully preserving the elasticity of the eardrum and the sharpness of hearing.

Indications for myringotomy

The otolaryngologist prescribes the procedure only when conservative treatment is ineffective, or the condition requires urgent action:

• Acute purulent otitis: severe pulsating pain, bulging eardrum, unmanageable high fever.
• Exudative (secretory) otitis: viscous, thick fluid (“glue ear”) has accumulated behind the eardrum, which does not drain on its own for more than a month and causes persistent hearing loss (especially common in children due to enlarged adenoids).
• Suspicion of intracranial complications (severe headache, dizziness against the background of otitis).
• Ineffectiveness of antibiotic therapy within 48-72 hours.

How is the procedure performed at St. Luke’s Clinic?

We understand that the procedure is frightening, so we ensure maximum psychological and physical comfort.

1. Anesthesia: The manipulation is performed under local anesthesia (special “freezing” drops or application). For small, frightened children, we offer myringotomy under light medical sleep (eliminates any pain and stress).
2. Microsurgical precision: The procedure is performed under the control of an otoscope or microscope. The surgeon uses a special spear-shaped micro-blade, making a perfectly even millimeter incision in the safe zone of the eardrum.
3. Cleaning: Fluid or pus flows out (if necessary, the doctor uses a vacuum micro-pump for delicate suction of thick mucus). Pain and pressure disappear literally at the same second!

* In cases of chronic exudative otitis (when fluid accumulates constantly), a microscopic ventilation tube (shunt) can be inserted into the created opening for long-term drainage.

Rehabilitation after the procedure

Immediately after myringotomy, body temperature drops, and the general condition sharply improves. Hearing begins to recover as the cavity clears.

For safe healing of the eardrum, it is necessary to:

• Strictly protect the ear from water (when washing hair, close the ear canal with a cotton swab soaked in petroleum jelly or oil).
• Do not visit swimming pools or dive until complete healing.
• Take antibiotics or drops prescribed by the doctor.
• Blow your nose carefully (one nostril at a time) to avoid creating pressure in the ears.

Don’t wait until the pain becomes unbearable! Sign up for expert ENT diagnostics at St. Luke’s Clinic for quick and safe hearing rescue.