Paracentesis of the eardrum

Tympanic membrane paracentesis is a microsurgical procedure during which a small incision is made in the tympanic membrane to evacuate pathological contents from the middle ear (pus, exudate). It is used for severe or prolonged otitis media when conservative treatment fails or there is a threat of rupture of the membrane, spread of infection to the inner ear or brain.

The procedure helps to relieve pain, restore ventilation of the tympanic cavity and speed up recovery, especially in children, who are often prone to complicated otitis media. It is safe, performed under local anaesthesia and lasts several minutes.

When to visit an otolaryngologist

Indications for paracentesis:

• acute purulent otitis media with severe pain and fever;
• presence of exudate behind the eardrum (exudative otitis media);
• hearing loss due to fluid accumulation in the middle ear;
• threat of membrane rupture in case of suppuration;
• frequent recurrence of otitis media, especially in children;
• no effect of antibiotic therapy within 48-72 hours.

Delaying the procedure can lead to complications such as mastoiditis, labyrinthitis, or intracranial infections.

When paracentesis is not performed

Contraindications may include:

• presence of pus already in the external auditory canal (means a rupture of the membrane);
• anatomical defects of the eardrum;
• allergy to local anaesthetics (in this case, an alternative is selected);
• general serious condition that requires stabilisation before the intervention;
• blood clotting disorders - performed in consultation with a haematologist.

How the procedure is performed

Paracentesis is performed in a sterile outpatient setting after a preliminary examination by an ENT doctor. Stages of the procedure:

1. Anaesthesia - local anaesthesia is applied in the form of drops or a cotton turundum with a drug.
2. Micro-incision - a small puncture is made in the lower quadrant of the eardrum using a special instrument.
3. Removal of contents - accumulated fluid or pus is carefully evacuated through the opening.
4. Follow-up examination - patency is checked and drainage is installed if necessary.
5. Bandaging or prescription of ear drops - to prevent re-infection.

In most cases, the hole closes on its own within 3-7 days. Full hearing recovery occurs after the swelling is reduced and the middle ear is cleaned.

How to prepare for paracentesis

Preparation is simple:

• bring previous ENT examinations, if available;
• do not instill antibacterial drops without a prescription;
• children should not eat 1-2 hours before the procedure (to avoid nausea);
• inform the doctor about medications or allergies;
• before the procedure, it is advisable to undergo an otoscopy and, if necessary, an ultrasound (if concomitant pathology is suspected).

Benefits of treatment at ZDRAVO clinic

At the ZDRAVO Medical Centre, paracentesis is performed by experienced otolaryngologists using modern micro-instruments that ensure the accuracy and safety of the intervention. The procedure is performed in sterile conditions in compliance with all infection control protocols. We guarantee an individual approach to each patient - both adults and children - and careful follow-up after the intervention. Our clinic offers online consultation, comprehensive examination (Check-Up), as well as support for patients with chronic otitis media, allergic diseases or immunodeficiency conditions.

What doctors and services can be additionally involved

In cases of concomitant pathologies or the need for diagnostics, the patient may be recommended to the following specialists:

• Children's Department - for paracentesis in children;
• Allergology - for frequent otitis media of allergic origin;
• Gastroenterology and immunology - in case of reduced immunity;
• Neurology - for symptoms of tinnitus, dizziness;
• Annual subscription - for long-term observation by ENT-specialist.

Contact ZDRAVO specialists - we will help you quickly, painlessly and safely eliminate inflammatory complications of the ear and avoid chronicity of the process.

Frequently asked questions about tympanic membrane paracentesis

1. Does paracentesis in the ear hurt?

The procedure is performed under local anaesthesia, so the patient does not feel pain. Sensations during the procedure are minimal, especially in adults. In children, everything goes quickly and delicately.

2. How long does it take for the eardrum to heal after a puncture?

In most cases, the hole heals on its own in 3-7 days. If the inflammation was severe or there are concomitant diseases (e.g. diabetes), the process may take a little longer.

3. Can hearing loss occur after paracentesis?

On the contrary, after the fluid is removed from the middle ear, hearing improves. Temporary hearing loss may occur if there is still swelling or exudate, but after treatment, the function is fully restored.

4. Do I need a sick leave after an ear piercing?

In most cases, no. However, if it is a child or a patient with severe otitis media, the doctor may issue a certificate for 2-5 days for home care and supervision.

5. Is there a risk of complications after the procedure?

Paracentesis is a safe procedure, but if you do not follow the recommendations (wet the ear, do not come for repeated examinations), there is a risk of secondary infection or prolonged inflammation. At ZDRAVO clinic, we carefully monitor each patient after the intervention.