Myringotomy with Tube Insertion
Make it stand out
Top: M&T Tray with additional instruments
Speculums 3, 3.5, 4, 4.5, 5
Curette
Myringotomy knife
#3 Frazier suction
Alligator forceps
Cup foreps
Rosen pick
#5 suction on suction tubing
Procedure steps:
Surgeon will visualize the eardrum with a speculum and microscope.
Removal of any ear wax or debris with curette
Myringotomy - incision into the tympanic membrane (eardrum)
-As the surgeon makes the incision, switch the #5 Frazier to the #3 Frazier
Tube insertion - RN will open specific type of tube upon request. Grasp with Alligator forcep and pass to surgeon.
-Hold hand under tube in the event it falls out of grasp, you can attempt to save it.
Surgeon will use Rosen pick to ensure proper placement
Instill ear drops (typically Ciprodex)
Suction may be needed at any point during the procedure, especially if the patient had a lot of fluid behind their tympanic membrane.
Cup forceps are available if there are any foreign bodies, or retained tubes from a previous procedure.
These procedures are FAST. The surgeon I work with can typically get each ear done in 1-2 minutes, so you’re not even at 5 minutes for the entire procedure. Always ensure the supply of tubes is fully stocked, you need minimum 2 for each procedure so ideally you would have minimum of 4 available. You should always have a 3 cc syringe, blunt hypo, and saline readily available (if not already opened) in the event the surgeon needs to irrigate debris.
