Myringotomy is an outpatient surgical procedure to create an incision in the eardrum (tympanic membrane). It is usually done before placing drainage tubes into the ears. It most often is recommended for children who have recurring ear infections (otitis media) or hearing problems due to fluid buildup in the middle ear space behind the eardrum. The tubes help to ventilate and drain fluid out of the middle ear and into the ear canal, restoring the normal functioning of the ear. Fluid in the ear may consist of blood, pus and/or water.

A myringotomy may be necessary for many reasons. For example, severe nasal allergies sometimes cause inflammation and blockage of the eustachian tube, which connects the nose to the middle ear. The tube is designed to allow air into the middle ear and to drain fluid from the ears into the nasal cavity. When the eustachian tube fails to work properly, a number of ear conditions can develop, including infections.

A healthcare provider might suggest myringotomy if a patient:

• Has experienced fluid buildup for more than three months in each ear and has significant hearing loss (20 decibels or more) in both ears.
  
  
• Has suffered recurring ear infections – usually, more than three episodes in a 12-month period.
  
  
• Is undergoing hyperbaric oxygen therapy, a treatment where oxygen is delivered to patients at values two to three times greater than atmospheric pressure.
  
  
• Has experienced barotrauma, injury to or discomfort in the ear caused by pressure differences between the inside and the outside of the eardrum. It most commonly occurs in people who have recently flown or been scuba diving.
  
  
• Has developed changes in the structure of the eardrum as the result of ear infections.
  
  
• Has a delay in speaking.  

Because infections tend to affect both ears, myringotomy is almost always performed on both ears. In some cases, the effectiveness of the treatment diminishes over time. Some patients will need to have tubes reinserted within five years.

The trend in recent years for many physicians has been to wait until a myringotomy is absolutely necessary before recommending the procedure be performed on young children. This is because the eustachian tube has a tendency to widen and function better as a child grows older. This policy of "watchful waiting" does not appear to cause any problems with the health or development of the child.