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myringotomy
Myringotomy (from Latin ''myringa'' "eardrum") is a surgical procedure in which a tiny incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. A tympanostomy tube is inserted into the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously in two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure.〔
Those requiring myringotomy usually have an obstructed or dysfunctional eustachian tube that is unable to perform drainage or ventilation in its usual fashion. Before the invention of antibiotics, myringotomy without tube placement was also used as a major treatment of severe acute otitis media (middle ear infection).
== History ==
In 1649, Jean Riolan the Younger accidentally pierced a patient's ear drum while cleaning it with an ear spoon. Surprisingly, the patient's hearing improved. There are also reports from the 17th and 18th centuries describing separate experiments exploring the function of the ear drum. In particular, the animal experiments of Thomas Willis were expanded upon by Sir Astley Cooper, who presented two papers to the Royal Society in 1801 on his observations that myringotomy could improve hearing. First, he showed that two patients with perforations of both eardrums could hear perfectly well, despite conventional wisdom that this would result in deafness. Second, he demonstrated that deafness caused by obstruction of the Eustachian tube could be relieved by myringotomy, which equalized the pressure on each side of the tympanic membrane.
Widespread inappropriate use of the procedure later led to it falling out of use. However, it was reintroduced by Hermann Schwartze in the 19th century. An inherent problem became recognized, namely the tendency of the tympanic membrane to heal spontaneously and rapidly, reversing the beneficial effects of the perforation. In order to prevent this, a tympanostomy tube, initially made of gold foil, was placed through the incision to prevent it from closing. Ádám Politzer, a Hungarian-born otologist practicing in Vienna, experimented with rubber in 1886. The vinyl tube used today was introduced by Armstrong in 1954.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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