Heat myringotomy

Heat myringotomy using a commercially available, battery powered device produced an opening in the tympanic membrane that persisted 1 to 3 weeks. The procedure was performed to treat chronic otitis media with effusion (COME) in lieu of ventilation tubes in 10 pediatric and 15 adult ears under office iontophoretic anesthesia. These patients were followed for a minimum of 3 months to assess efficacy. Fifty percent of pediatric ears were controlled, eliminating the need for general anesthesia and tube insertion. Forty percent of adult ears were controlled with heat myringotomy. A description of the procedure, discussion of possible reasons for failure, and analysis of potential cost savings are included.