Paracentesis

Paracentesis (from the Greek. parakentesis - puncture, puncture; synonymous with tympanotomy) - section eardrums; put into practice for emptying tympanic cavity from the exudate in acute purulent otitis media. After paracentesis usually disappears ear pain, temperature decreases, improves the General condition of the patient.
Paracentesis should do patients with acute otitis media (see) if unsuccessful conservative treatment. Signs of irritation of the inner ear or the meninges (severe headache, dizziness, nausea, chills, and so on) is an indication for urgent paracentesis. Statement of the evidence to P. in infants is a little complicated. They eardrum is sometimes little changed in the presence of a cavity of a purulent exudate, and often hyperemia membranes masks endothelial the epidermis. In young children suffering from infectious toxic diseases of the gastrointestinal tract, changes from the eardrum and purulent otitis are often very small, blurred (loss Shine eardrum, some turbidity, stosowanej arm hammer); sometimes there is a focal yellow-grey or yellow staining while maintaining the identification of points. Meanwhile, otitis media is sometimes the cause of intoxication. In such cases, indications for paracentesis expanded. There is an opinion that the PA dangerous for the hearing of the ear. In fact, he created the drainage of purulent warns organization of the exudate and education of cicatrices and scars, which are often a cause of persistent decrease in hearing after acute otitis media. Operation is carried out usually with no anesthesia. Restless patients can be given Rausch-anaesthesia.
Paracentesis make a straight or bent at a sharp angle needle spear shape. When otoscopy (see) set the cut (not uncommon expressed bulging tympanic membrane) and fast movement pierce immediately all the membrane (Fig.). The needle should not be deeply to work in order to avoid damage to the internal wall of the tympanic cavity. When properly conducted by complications usually not the case. After P. injected into the ear canal sterile wool or cotton wool, which then change as you soak. After the termination of sickness from the ear cut edges are converging.
In connection with the successful treatment of otitis media with antibiotics paracentesis are used less frequently. Some doctors believe P. even unnecessary. However, this view is not justified. Disclaimer P. if there is evidence to it can lead to permanent and sudden hearing loss after acute otitis media. Sometimes P. remains the most effective method of treatment of otitis and prevention caused them loss of hearing. Cm. also Tympanophonia.

The scheme of the operation of paracentesis right eardrum; top right - line typical section of the eardrum.