Improvised Venous Canula Myringostomy in Acute Otitis Media: Analysis of outcome in Nigeris

Background : This case control study was based on the hypothesis that myringostomy done on an a bulging but inflamed tympanic membrane before perforation might improve healing of the middle ear and tympanic membrane, thus reducing the probability of progression to chronic suppurative otitis media. Our objective was to compare outcome of tympanic membrane healing in acute otitis media (AOM) patients who had myringostomy and those presenting with perforation and suppuration. In this study we also examined the suitability of a venous canula as an improvisation in the absence of conventional myringostomy tube.
Methods :This prospective study, carried out in the Otolaryngology Unit, Department of Surgery, Federal Medical Center, Lokoja between February 2006 and August 2008, included consecutive AOM patients who presented with excruciating otalgia and bulging, hyperaemic tympanic membrane and another group with ruptured tympanic membrane both within 2 weeks duration. The patients with bulging tympanic membrane had venous canula myringostomy done in the local anaesthesia and the canula was kept in situ until the ear became dry and until the myringostomy site closed up. While the group with tympanic membrane perforation at presentation had ear suction toileting and daily ear dressing, until ear became dry. The 2 groups were followed up daily to determine duration of stay of the improvised myringostomy tube and the closure of the myringostomy site or tympanic membrane perforation and they were compared using Pearson’s correlation test at 0. 05 significance.
Results : Subjects comprised of 42 AOM (15 males and 27 females (M: F = 1.7:3) and 26 with tympanic membrane perforation (11 males and 15 females), aged between 3 years to 48 years (mean+ SD = 13+ 6 years). Relief of otalgia was seen all the subjects in the myringostomy group (100%). The mean number of days to achieve dry ear after myringostomy tube was 3 days after myringostomy while it was 3 weeks in the perforation group (P = 0.002). The mean number of days to achieve closure of the myringostomy was 3.7 days after dryness while among the perforation group, it was 3 months (P= 0.000).
Conclusion : Venous canula, which is cheap and readily available, could be an improvisation for myringostomy in AOM; and this aided early relief of otalgia, resolution of disease and significant reduction in treatment durations.