Ear drainage

Incision of the tympanic membrane.

Indication

Acute otitis with fever, intense pain, and an inflamed distended non-perforated tympanic membrane.

Material

Drainage needle

Otoscope with a light or a speculum with a head-light.

Technique

Figures 71, 72

While viewing the membrane, and without anesthesia, make a radial incision in the posterior-inferior quadrant with a stylet or a special lancet.

Aspirate the pus with a soft catheter, gently removing the serous fluid and pack gently with cotton.

Antibiotic therapy

Systemic:

Ampicillin if less then 5 years of age: 100 mg/kg/day PO x 3 -10 days

Phenoxymethyl penicillin / Penicillin V older than 5 years of age:

Adult : 3 x 2 tablets/day (tablets of 400.000 U)
Child : 50 to 100.000 U/kg/day x 5 to 10 days, or procaine penicillin or PPF

FIGURE

100.000 U/kg/day x 3 days, followed by penicillin V during 4 to 6 days.

Erythromycine for those allergic to betalactamines:

Adult : 1 g in 3 divided doses/day x 10 days
Child : 50 mg/kg/day in 3 divided doses/day x 10 days