myringotomy and grommet tube insertion

​What is examination of ears keep in view (KIV) myringotomy and grommet tube insertion?

An ear examination is performed under the microscope to evaluate presence of abnormalities in the ear canal and middle ear. Any debris in the ear canals is removed to allow inspection of the eardrum. If there is fluid in the middle ear (otitis media with effusion), a small cut is made on the eardrum (myringotomy) and a ventilation tube (grommet tube) is placed in the cut.

Why do I need this procedure?

This procedure is needed if you have either or all of the following condition(s):

1. An abnormality of the ear canal that prevents full examination of the ear canal and the eardrum. Such as infections (e.g. otitis externa), structural abnormalities (e.g. narrow ear canals, impacted earwax) or growths (e.g. Cholesteatoma and foreign bodies).
   
2. Possible fluid or infection of the middle ear that requires ventilation tube insertion. Examining the ear under anaesthesia and performing a myringotomy confirms the diagnosis of middle ear fluid. Placement of a ventilation tube aerates the middle ear and resolves hearing loss secondary to the middle ear fluid.

What does it involve?

The procedure can be performed under local anaesthesia or under general anaesthesia. The type of anaesthesia depends on the patient’s tolerance level.

A microscope is used to inspect the ear canal. Any dirt/debris is cleaned out with microscopic instruments. The eardrum is inspected for abnormalities and the presence of fluid in the middle ear. A microscopic knife is used to make a small cut along the eardrum. If there is no fluid in the middle ear, the procedure is complete. If there is fluid, it is suctioned out and a ventilation tube (grommet tube) is placed in the opening. The tube has a hollow passage in the centre that allows air to enter the middle ear. The deep end of the tube sits in the middle ear and the other end sits in the ear canal. There will be no external cuts or scars.

Ventilation tubes are temporary and will eventually fall out on their own.

​What precautions must I take for the procedure?

Please inform your doctor/nurse if you are ill on the day of surgery as the surgery may need to be postponed.