Paracentesis (ENT)

This is a surgical procedure that is most often used for otitis media. Indications for paracentesis are bulging of the eardrum accompanied by inflammatory changes that cause the patient pain and persistent fever.

Performing the procedure

The procedure itself takes about 10-15 seconds and is performed under local or general anesthesia. In most cases, however, the procedure is not painful for patients because the tangle of nerve endings is not so dense in the ear drum. An artificial perforation of the ear drum in the posterior lower quadrant is performed using a scoop knife. In this area is the largest bulging of the tympanic membrane, which caused the accumulation of secretions. After the tympanic membrane is punctured, a suction device is inserted to collect the secretion, which begins to flow out of the middle ear under pressure. The secretion that comes out is also taken for microbiological examination.

Positives of the procedure

Paracentesis helps relieve pain caused by inflammation. Healing itself after the procedure is much easier than healing a wound with spontaneous perforation. Paracentesis also acts preventively against the spread of infection and toxic products of inflammation into the intracranial cavity. After the procedure, residual pus with admixture of blood may appear for a few hours after the perforation of the ear drum. It is therefore necessary to check the patient in 24 to 48 hours. Administration of antibiotics should be considered individually according to need.

Treatment

After paracentesis, ear pain may persist for several days. However, within a week, the hole in the eardrum will heal itself and there will be no permanent consequences. For the correct course of treatment, the ear should not come into contact with liquids and dirt that could re-trigger the inflammation or cause the ear to become blocked with subsequent murmurs.

Related Articles

• Acute otitis media

External links

• Paracentesis – video

References

• HAHN, Aleš, et al. Otorinolaryngologie a foniatrie v současné praxi. 1.  edition. Prague : Grada, 2007. 390 pp. ISBN 978-80-247-0529-3.

• KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. edition. Prague : Galén, 2005. 224 pp. ISBN 80-7262-346-X.

• HYBÁŠEK, Ivan – VOKURKA, Jan. Otorinolaryngologie. 2.  edition. Prague : Karolinum, 2006. 426 pp. ISBN 80-246-1019-1.