TYMPANOPUNCTURE (Greek tympanon drum + lat. punctio a prick) — the puncture of a tympanic membrane which is carried out with the diagnostic or medical purpose.
T., carried out with the diagnostic purpose, allows to receive contents of a drum cavity for specification of character of microflora at otitis. Komper (W. E. Compere), etc. recommend to apply T. for introduction to a drum cavity of a contrast agent at a X-ray analysis both the cavity, and eustachian (acoustical, T.) pipes with a research objective of its drainage function. According to Miller and Formen (M. of Miller, F. Forman), T. it can be used for administration of anesthetic in a drum cavity for temporary switching off (masking) better than the hearing ear at audiometriya (see).
With to lay down. purpose T. it is shown at hard proceeding acute average otitis (see) with the phenomena of the general intoxication, severe pain in an ear, the elevated temperature of a body expressed by changes tympanic membrane (see). At the same time enter pharmaceuticals, napr, antibiotics, directly into a drum cavity.
At defeat of a facial nerve, the phenomena of irritation of an inner ear, a meninx (dizziness, nausea, vomiting, a nystagmus, etc.). T. it is contraindicated. In such cases it is necessary to make a tympanotomy (see. Paracentesis ) or operation on a mastoid — an antrotomy, a simple mastoidotomy (see. Mastoid ).
Anesthesia at T. is more often local, superficial, by injection in an ear of 5 — 10% of solution of cocaine or introduction of 0,5 ml of 2% of solution of novocaine to a posterosuperior wall of outside acoustical pass. In some cases resort to an anesthesia.
T. with the diagnostic purpose (suctions of contents of a drum cavity) make for a microbiological research by means of the fine needle connected to the special syringe. T. with the medical purpose make by means of the ordinary syringe with a capacity of 1 — 2 ml. The patient is stacked on a back, having turned his head on one side, down a healthy ear. The child is densely swaddled, reliably fixing his extremities. The auricle, outside acoustical pass and a tympanic membrane are processed alcohol (the last by an instillation). Then, having entered an ear speculum, under control of sight into the typical place (a zadnenizhny quadrant of a tympanic membrane) or into the site of the greatest protrusion enter the needle connected to the syringe on depth of 1,5 — 2 mm, and through it — the solution of medicine which is warmed up to t ° 37 °. Poperkhivaniye and release of medicine from a nose demonstrates the correct carrying out T. and satisfactory passability of an Eustachian tube.
During the use of liquid, temperature the cut does not correspond to body temperature, perhaps caloric irritation of an inner ear which is followed by a rotatory vertigo, a nystagmus, nausea, vomiting. At too deep introduction of a needle the injury of a secondary tympanic membrane with the subsequent switching off of functions of an inner ear is possible.
Yu. B. Preobrazhensky.