Any ear disease is a very unpleasant thing. If you start treatment at an early stage, then it is quite possible to cope with the problem with the help of a warming compress and anti-inflammatory drugs. When the disease is started, it is often complicated by the accumulation of purulent discharge, which is very dangerous. Pus presses on the eardrum, causing it to become inflamed and bulging. As a result, hearing is sharply reduced and many unpleasant symptoms appear: fever, severe headaches and ear pains, noise and ringing in the ears. In this case, you often have to resort to such an unpleasant procedure as a puncture of the eardrum.
Indications for the procedure
A puncture (paracentesis) of the tympanic membrane performed by a qualified specialist under sterile conditions is an absolutely safe procedure. However, in modern conditions, it is performed only in extreme cases, when other methods of treatment have not yielded results or the disease has been too advanced (usually after improper treatment at home).
Unconditional indications for the procedure are:
- chronic or acute purulent otitis media;
- chronic inflammation of the middle ear with fluid accumulation;
- signs of irritation and / or inflammation of the meninges.
Usually, these diseases are accompanied by symptoms such as nausea, dizziness, severe throbbing pains, a feeling of internal pressure, an increase in body temperature.
If the doctor decides to resort to paracentesis, then you should not abandon the procedure. As a rule, this means that there is no other way to alleviate the patient's condition and speed up recovery. And if in such a situation you do not puncture the eardrum in time, the consequences can be extremely serious: meningitis, sepsis, etc.
How is the puncture performed
The method of performing the procedure is the same for children and adults, it is carried out in several stages:
- Thorough cleansing of the external ear canal of dirt, wax and other secretions.
- Additional control examination and determination of the puncture site.
- Treatment of the external auditory canal and tympanic membrane with an antiseptic solution.
- Execution of a puncture with a special spear-shaped instrument.
- Tilting and holding the head in this position for some time to drain the fluid.
- Re-treatment of the ear canal with an antiseptic.
- Placement of a sterile gauze swab that will absorb the exudate.
Then a sterile bandage is applied to the ear, which is removed during the first day only to replace the gauze swab.
The whole procedure takes no more than 15 minutes and in most cases is carried out without strong anesthesia, and the sensitivity of the tympanic membrane is reduced by its preliminary treatment with novocaine or lidocaine. If the patient is too nervous, mild sedatives may be used before the procedure (for adults only!).
Prevention of complications
With proper paracentesis, no complications arise. On the contrary, it quickly and significantly relieves the patient's condition. The puncture site heals in a few days and hearing is fully restored. Sometimes, if there is too much pus and fluid, an elastic tube is inserted into the ear to prevent the membrane from quickly growing together, which is removed after the fluid stops secreting.
After the procedure, it is very important to continue to maintain sterility, since infection in the wound can provoke a repeated exacerbation of the disease. Therefore, it is necessary to change the gauze swab 2-3 times a day, and also to monitor the cleanliness of the outer bandage, which can only be removed with the permission of the attending physician.
Often, after the procedure, the patient is prescribed a course of antibiotics. They also must be drunk. This will speed up recovery and serve as an excellent prevention of relapse.
Rumors and facts
Oddly enough, there are still a lot of rumors around this rather simple procedure that frighten patients. The consequence of elementary illiteracy is the unmotivated refusal of patients to carry out the procedure in a timely manner. This leads to an aggravation of their condition and the development of complications.
Here are the main fears of patients and qualified medical answers to them:
- Eardrum paracentesis is a very painful procedure. No. The puncture is made with a very fast movement, and after the accumulated fluid begins to come out, the pain in the ear gradually subsides.
- A piercing increases the risk of ear infection. It is the infection that has penetrated earlier that provokes the development of purulent otitis media. After a puncture (which is performed with sterile instruments!), The pus comes out and the risk of the infection spreading further is significantly reduced.
- Repeated repetition of the procedure leads to hearing loss. Partially true. If the puncture is repeated often at short intervals, then scars on the tympanic membrane may form, due to which it becomes denser and its sensitivity decreases.
- Eardrum paracentesis in children under 24 months of age can lead to serious complications. Although in most cases otitis media in babies goes away without special treatment, with a significant accumulation of fluid, you have to resort to a puncture. Otherwise, it will not be possible to relieve the child of severe pain and prevent further infection.
As you can see, most puncture fears are unfounded. The procedure itself is simple and not dangerous. In addition, it has been performed since the middle of the 18th century and then was often the only way to save hopeless patients. The main thing is to strictly follow all the doctor's prescriptions after it is carried out, which will contribute to a speedy recovery.
