Myringotomy 1886. The vinyl tube used today was introduced by Beverley Armstrong in 1954. There are numerous indications for tympanostomy in the pediatric age group, the most frequent including chronic otitis media with effusion (OME) which is unresponsive to antibiotics, and recurrent otitis media. Adult indications differ somewhat and include Eustachian tube dysfunction with recurrent signs and symptoms, including fluctuating hearing loss, vertigo, tinnitus, and a severe retraction pocket in the tympanic membrane. Recurrent episodes of barotrauma, especially with flying, diving, or hyperbaric chamber treatment, may merit consideration. Myringotomy is usually performed as an outpatient procedure. General anesthesia is preferred in
Modified Gibson Incision Modified Gibson Incision The Modified Gibson incision is a transverse incision above the pubis, frequently used in gynecological and urological surgeries. This incision can be made on either side of the midline, but often on the left. It is started 3 cm above and parallel to the inguinal ligament and extended vertically 3 cm medial to the anterior superior iliac spine up to the umbilicus. The modified Gibson incision allows proper access to the small bowel and pelvic organs and limited access to omentum. It is also possible to have tactile assessment of large bowel and subdiaphragmatic surfaces using this