Myringotomy: Relieving Middle Ear Pressure and Restoring Hearing
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Myringotomy is a short surgery in which an ear, nose, and throat (ENT) surgeon makes a tiny hole in the eardrum to drain trapped fluid, such as water, blood, or pus, from the middle ear. It is often done together with ear tube placement [1].
Quick Answer: What is a myringotomy?
A myringotomy is a surgery in which an ENT surgeon makes a tiny hole in the eardrum to relieve pressure and drain middle ear fluid, taking about 15 to 20 minutes. It is common for children with frequent ear infections or glue ear, often with ear tube placement. Most people recover within days; report fever, bleeding or lasting dizziness. [1]
What the research says
Guidelines reserve ear tubes for persistent fluid with hearing problems, or for frequent infections with fluid present. The 2022 American Academy of Otolaryngology-Head and Neck Surgery Foundation guideline recommends offering tubes to children with fluid in both ears for 3 months or longer and documented hearing difficulties, advises against tubes for a single episode of fluid lasting less than 3 months, and advises against routine water precautions (earplugs, headbands, avoiding swimming) for children who have tubes (Rosenfeld et al., Otolaryngol Head Neck Surg, 2022).
Tubes help hearing in the short term, but the benefit fades. A Cochrane review of 10 trials (1,728 participants) found hearing about 12 dB better at 3 months in one high-quality trial of 211 children (95% CI 10 to 14 dB) and about 4 dB better at 6 to 9 months across three trials (95% CI 2 to 6 dB), with no difference in hearing levels at 12 and 18 months (Browning et al., Cochrane Database Syst Rev, 2010).
Tubes reduce persistent fluid, but long-term hearing outcomes look similar. A 2023 Cochrane review of 19 trials (2,888 children) reported that, compared with no treatment, tubes may markedly reduce persistent fluid at 6 months (20.4% vs 68.0%; RR 0.30, 95% CI 0.14 to 0.65; one study of 54 children, low-certainty evidence), while early tubes versus watchful waiting made little to no difference in the proportion with normal hearing after 8 to 10 years (93% vs 95%); most of the evidence was rated very uncertain (MacKeith et al., Cochrane Database Syst Rev, 2023).
What Is Myringotomy?
Myringotomy is a surgery that focuses on the tympanic membrane (eardrum), the thin tissue that separates the outer ear canal from the middle ear. When fluid becomes trapped in the middle ear, it can cause pain, pressure, and muffled hearing. A myringotomy gives that fluid a direct path out, which can relieve symptoms and help protect the delicate structures of the ear. You might need it in one ear or in both ears (bilateral myringotomy) [1].
Surgeons do more myringotomies on children than adults because young people are more prone to ear infections. Many adults need the procedure too, usually because of barotrauma, an injury caused by rapid changes in air or water pressure [1].
Which conditions does myringotomy treat?
Myringotomy helps drain fluid trapped in the middle ear, whether it is water, blood, or pus. The table below outlines the main reasons for the procedure [1].
Condition | Description | Primary Goal |
Chronic otitis media | Frequent or persistent ear infections. | Drain pus and help prevent recurrence. |
Glue ear | Thick, sticky fluid buildup in the middle ear. | Remove the blockage and restore hearing. |
Ear barotrauma | Painful pressure injury from changes in air or water pressure, as with flying or diving. | Equalize pressure and relieve pain. |
Ruptured eardrum or ear bleeding | Bleeding or infection after trauma or a severe infection. | Drain blood and allow controlled healing. |
Hearing loss | Muffled hearing caused by fluid in the middle ear. | Clear the path for sound. |
How is a myringotomy performed?
A myringotomy usually takes about 15 to 20 minutes. Surgeons usually perform it under general anesthesia, particularly for children, but may use a topical anesthetic instead depending on the situation. You should not feel pain during the procedure [1]. Before surgery, your healthcare provider will give you specific instructions. In general, you should not eat or drink anything after midnight the night before, and you will need someone you trust to drive you to and from the appointment.
Steps of the Operation
The surgeon first looks at your eardrum up close through a small microscope. Using specialized instruments, they then make a tiny incision (hole) in the eardrum and use a gentle suction device to remove the trapped fluid [1].
In many cases, the surgeon also performs a tympanostomy, placing a small tube into the incision. The tube equalizes pressure in the ear and helps prevent infections from returning. Ear tubes are designed to stay in place for several months, providing continuous ventilation of the middle ear until they fall out [1].
Immediate Post-Operative Care
Because the incision is so small, you probably will not need stitches; it should heal on its own. Instead, the surgeon may pack your ear with gauze to absorb initial drainage. You are monitored in a recovery area until the anesthesia wears off, and most people can go home the same day [1].
What are the benefits of myringotomy, and what is recovery like?
The main benefit of myringotomy is relief of distressing symptoms and restored ear function [1]:
Pain relief: Draining the fluid eases the pressure that causes ear pain.
Hearing restoration: Clearing the middle ear lets the eardrum vibrate freely, which restores clarity to sound.
Improved balance: Fluid in the ear can disrupt balance, and draining it can help.
Fewer infections: Myringotomy, especially with ear tubes, can reduce how often ear infections happen.
Developmental support: In children, restoring hearing supports speech development and school performance.
Recovery Guidelines
Most people feel better within a day or two and can go back to work or school within a couple of days. Clear or yellow drainage from the ear for up to about three days is normal and means the surgery was successful; tell your surgeon if drainage lasts longer than a week. You may have slight ear discomfort or a clogged feeling for a day or two, and some dizziness or balance trouble is possible for a few days [1].
General instructions after surgery include avoiding putting your head underwater, avoiding shaking your head hard for about a month, taking all medicines exactly as directed, and wearing earplugs when you bathe, shower, or swim. Your healthcare provider will give you instructions specific to you [1].
Recovery Milestone | Timeline | Expected Experience |
Initial healing | 1 to 2 days | Reduced pain, slight dizziness, minor drainage. |
Return to routine | 2 to 5 days | Return to work or school and improved hearing. |
Full stabilization | About 4 weeks | The incision closes if no tube was placed, and you return to all activities as your surgeon advises. |
A note on water precautions: practice varies. Cleveland Clinic advises earplugs for bathing, showering, and swimming after myringotomy, whereas the 2022 guideline for children who have ear tubes advises against routine, prophylactic water precautions such as earplugs, headbands, or avoiding swimming (Rosenfeld et al., 2022). Follow your own surgeon's instructions.
What are the risks and warning signs after myringotomy?
Myringotomy is a safe and common procedure, but like any surgery it carries general risks such as infection, excess bleeding, or a negative reaction to anesthesia. Specific complications include scarring or hardening of the eardrum (tympanosclerosis), which can cause hearing problems, ear drainage that does not go away after a few days, injury to the ear canal, and, rarely, a permanent hole in the eardrum that does not heal [1].
Contact your healthcare provider if you notice any of the following [1]:
Fever or chills, which can be signs of infection.
Excessive bleeding, or drainage that has a bad smell or lasts longer than a week.
Dizziness that lasts longer than 12 hours.
Muffled hearing that lasts more than a few days.
Pain that does not get better with medication.
Skin discoloration or swelling around the ear.
What is the bottom line on myringotomy?
Myringotomy is a fundamental surgical tool for managing middle ear health. By giving trapped fluid a safe way out, it can relieve pain and pressure, restore hearing, and, when combined with ear tubes, help prevent fluid from returning. If you or your child has chronic ear problems, talk with an ENT specialist about whether this brief procedure is the right path to long-term relief [1].
Frequently Asked Questions
Does myringotomy always require ear tubes?
No. A myringotomy can be done on its own just to drain fluid, but surgeons often place ear tubes (tympanostomy) in the same procedure to keep the middle ear ventilated and prevent fluid from returning, especially when the problem is chronic.
How long does the incision take to heal?
If no tube is placed, the tiny incision typically heals on its own within a few weeks. If a tube is placed, the opening stays open around the tube until the tube falls out, after which the eardrum usually closes.
Can my child go to school the day after surgery?
Many children can return to school within one to two days. Slight dizziness or drainage can occur, but severe pain is uncommon. Ask your child's surgeon when it is safe to resume normal routines.
Is the procedure painful?
No. The surgery is done under anesthesia, so you should not feel pain during it. Afterward there may be mild discomfort or a clogged feeling in the ear for a day or two, which your healthcare provider can help you manage with medication.
Why is the procedure more common in children?
Children have shorter, more horizontal Eustachian tubes, which makes it easier for bacteria and fluid to become trapped in the middle ear. As they grow, the tubes become more vertical and drain more effectively.
What happens to the fluid that is removed?
The surgeon uses a small suction device to gently remove the fluid through the incision. In some cases, pus-like fluid may be sent to a lab to identify the bacteria causing the infection.
Do I need to wear earplugs after surgery?
Many surgeons recommend earplugs when bathing, showering, or swimming during recovery to keep water out of the incision or tube. However, the 2022 guideline for children with ear tubes advises against routine, prophylactic water precautions. Your surgeon will tell you what applies to you and when it is safe to stop.
Will myringotomy fix all types of hearing loss?
No. It treats hearing loss caused by fluid in the middle ear (conductive hearing loss). It does not treat sensorineural hearing loss, which is caused by damage to the inner ear or the auditory nerve.
Can I fly after having a myringotomy?
Ear tubes can make flying more comfortable because the opening lets the ear equalize pressure, which can prevent the pain or popping felt during takeoff and landing. If you have had a myringotomy, ask your surgeon when it is safe to fly.
What are the signs that the surgery did not work?
Fluid returning quickly, drainage lasting longer than a week, or hearing that does not improve after the initial recovery period may mean the problem has not been fully resolved, and you should be evaluated by an ENT specialist.
How do I prepare for a myringotomy?
Your healthcare provider will give you specific instructions. In general, you should not eat or drink anything after midnight the night before, and you will need someone you trust to drive you to and from the appointment [1].
When should I call my doctor after a myringotomy?
Contact your healthcare provider for fever or chills, excessive bleeding, drainage that smells bad or lasts longer than a week, dizziness lasting more than 12 hours, muffled hearing that lasts more than a few days, pain that does not improve with medication, or skin discoloration or swelling around the ear [1].
Related Reading
References
Cleveland Clinic. Myringotomy. Cleveland Clinic. November 20, 2024. https://my.clevelandclinic.org/health/procedures/myringotomy
Rosenfeld RM, Tunkel DE, Schwartz SR, et al. Clinical practice guideline: tympanostomy tubes in children (update). Otolaryngol Head Neck Surg. 2022;166(1_suppl):S1-S55. PMID: 35138954. DOI: 10.1177/01945998211065662
Browning GG, Rovers MM, Williamson I, et al. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2010;(10):CD001801. PMID: 20927726. DOI: 10.1002/14651858.CD001801.pub3
MacKeith S, Mulvaney CA, Galbraith K, et al. Ventilation tubes (grommets) for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2023;11(11):CD015215. PMID: 37965944. DOI: 10.1002/14651858.CD015215.pub2
Medical disclaimer
The information provided in this article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
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