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Ear Disorders

Myringotomy with Tube Placement

Myringotomy means a surgically-created hole in the ear drum. After a myringotomy is performed a tube is often placed in the hole to keep it open. This procedure is designed to allow equalization of pressure between the middle ear space and the outside environment. Myringotomy and tube placement are necessary when the Eustachian tube (natural ventilation duct between the throat and middle ear) does not function properly. Generally, the pressure equalizing tube placed at the time of surgery remains in the ear drum anywhere between 4-18 months. Variable ear drum healing and different types of tubes can make this duration shorter or longer. The procedure is usually performed under local anesthesia (numbing medication only) in adults and general anesthesia (completely asleep) in children.

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Otitis Externa

Otitis externa or "swimmers ear" is a bacterial or fungal infection of the ear canal skin. When water is retained in the ear canal for prolonged periods of time, microbial growth is promoted. This results in painful inflammation of the thin ear canal skin. Small ear canals, eczematous (itchy with flaking skin) ear canals and ear wax accumulation are risk factors for otitis externa because these conditions prevent adequate drainage or evaporation of moisture from the canal. Staphylococcus and Pseudomonas bacterial species are the most common organisms found causing otitis externa. Fungal infections, which are less common, are usually attributed to Aspergillus species and Candida (yeast). Treatment of otitis externa involves 1) thoroughly cleaning the ear canal (accomplished in your ENT doctor's office with a microscope and small suction instrument), 2) eliminating the overgrowth of microbes (antibacterial or antifungal agents), 3) pain management and 4) maintaining a relatively dry ear canal.

Prevent moisture in the ear canal

Follow up with your ENT doctor periodically to address wax and dead skin build up in the ear canal. Removing this material will help prevent moisture accumulation in the canal. After showering or swimming gently wipe excess water from the opening of the ear canal (NOT the inside of the ear canal) with a tissue. Avoid using cotton-tip applicators (such as Q-tipsĀ®) in the ear canal. The cotton-tips can push wax and debris further into the ear canal and cause small breaks in the delicate ear canal skin providing an opportunity for bacteria and fungus to cause infection). Waving a hair dryer a few to several inches from the ear canal opening can help dry the canal. Be careful not to burn your ear with the dryer. Remember to discuss simple and effective home remedies to prevent recurrent otitis externa with your ENT doctor.

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