Further Outpatient Care

See the list below:

Carry out general antibacterial and anti-inflammatory therapy on outpatient basis.
Remove the packing from the canal after 7-14 days. Clean out the canal and recommend eardrops 3 times per day until healing is complete.

Inpatient & Outpatient Medications

See the list below:

See External Ear, Inflammatory Diseases and External Otitis, Complications of Otitis Media.

Deterrence/Prevention

See the list below:

Advise patients to protect ears from water in pools or in the shower and to avoid trauma to the EAC and the TM from removal of earwax. Patients who have recurrent episodes of myringitis should be taught to use 70% propyl alcohol or acidifying drops after every exposure to water.

Complications

See the list below:

See Middle Ear, Chronic Suppurative Otitis, Surgical Treatment
See Complications of Otitis Media
Hearing loss (both sensorineural and conductive)
Tympanic membrane perforation
Facial Paralysis
Vertigo/dizziness
Extension of suppurative process to surrounding structures (coalescent mastoiditis, meningitis, abscess, sigmoid sinus thrombosis)

Prognosis

In most cases, patients with myringitis have a favorable prognosis. In case of destruction of the new TM, the surgeon may assess the reasons for the failure and repeat myringoplasty with necessary corrections.

A retrospective, nationwide cohort study from Sweden, by Berglund et al, of patients who underwent myringoplasty found that there was an average 8.8 dB postoperative improvement in pure-tone average. The air-bone gap closed to less than 20 dB in 89% of ears, and to 10 dB or less in 51% of ears. While hearing improved in 61% of patients in whom hearing had deteriorated preoperatively, 3% of patients suffered postoperative hearing deterioration.^[11]

Patient Education

See the list below:

Instruct patients to protect the EAC from penetration of water while washing hair or taking a shower.
For excellent patient education resources, visit eMedicineHealth's Ear, Nose, and Throat Center. Also, see eMedicineHealth's patient education articles Earache and Earwax.

Questions

Media Gallery

Tympanic membrane (TM) as continuation of the upper wall of external auditory canal (EAC) with angle of incline up to 45 degrees on the border between middle ear and the EAC.
Normal tympanic membrane. Pars tensa (PT), pars flaccida (PF), light reflex (LR), fibrous ring (FR), umbo (Um), handle of malleus (HM), lateral process of malleus (Lpm), anterior plica (AP), posterior plica (PP).
Mirror display of a tympanic membrane surface on the polymeric masc from external acoustical canal of healthy man. Masc of tympanic membrane surface (MtmS).

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Author

John Schweinfurth, MD Professor, Department of Otolaryngology, University of Mississippi Medical Center

John Schweinfurth, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Laryngological Association, Triological Society, American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Yuri P Uliyanov, MD, PhD Director, Department of Ear, Nose, and Throat, Agami Medical Center

Yuri P Uliyanov, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Gerard J Gianoli, MD Clinical Associate Professor, Departments of Otolaryngology-Head and Neck Surgery and Pediatrics, Tulane University School of Medicine; President, The Ear and Balance Institute; Board of Directors, Ponchartrain Surgery Center

Gerard J Gianoli, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Neurotology Society, American Otological Society, Society of University Otolaryngologists-Head and Neck Surgeons, Triological Society

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan, Ryte, Neosoma, MI10<br/>Received income in an amount equal to or greater than $250 from: , Cliexa;;Neosoma<br/> Received ownership interest from Cerescan for consulting; for: Neosoma, eMedevents, MI10.

Additional Contributors

Michael E Hoffer, MD Director, Spatial Orientation Center, Department of Otolaryngology, Naval Medical Center of San Diego

Michael E Hoffer, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Received royalty from American biloogical group for other.