wall, and the second extends directly upward to a point between the meatus and the
upper edge of the auricle, where the two incisions join.
b. The high posterior incision may be used in operations on infants or young
children. The incision is placed at a higher posterior level than is the endaural incision,
thereby avoiding possible damage to the facial nerve.
c. The postaural incision may be used to expose the mastoid process. It follows
the curve of the postaural fold, beginning at the upper attachment of the auricle and
continuing behind the postaural fold downward to the tip of the mastoid process.
d. For stapes surgery, a circumferential incision is made in the posterior half of
the canal, starting at the inferior aspect of the annulus and ending posterior to the short
process of the malleus.
e. For myringotomy, a circumferential (posteroinferior) incision is made. It
provides for wide drainage and removal of pus or fluid under pressure from the middle
a. General. Myringotomy is an incision through the tympanic membrane. This
may be done when an inner ear infection produces pus that is causing undue pressure
on the membrane. It may also be done to correct hearing loss due to fluids in the
b. Preparation of the Operating Room. Sterile instruments are set up in
accordance with local policy and the surgeon's preference. Non-instrument items in the
setup include cotton-tipped applicators, cotton (for plugging the canal after surgery), and
c. Operative Procedure.
(1) Through microscopic visualization, the aural speculum is inserted in the
canal. Using a sharp myringotomy knife, a small curved incision is made in the
posteroinferior quadrant or the pars tensa, and the thickened membrane is cut.
A culture is taken to determine the type of organisms present.
Pus and fluids are suctioned out.
A plastic tympanotomy tube prosthesis is usually put into place.