Micropuncture of the tympanic membrane after tympanoplasty

Shortly after tympanoplasty the cause of conductive hearing loss may be difficult to ascertain. If the cause is related to poor eustachian tube function, early aeration of the middle ear should produce an immediate improvement in hearing. A procedure for aerating the middle ear consists of introducing 0.5 cc of air through the graft with a tuberculin syringe and an angled 1.25-inch, 27-gauge needle. Between 1978 and 1983, 75 patients, or 19% of those having tympanoplasties or mastoid tympanoplasties, underwent the micropuncture procedure. Forty-five patients had a hearing improvement after the procedure and there were no complications. It appears that micropuncture of the tympanic membrane is an easily performed, relatively painless, safe procedure after tympanoplasty. It is a useful diagnostic procedure that may also improve the ultimate results of tympanoplasty surgery.