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
River incision River incision River incision is the narrow erosion caused by a river or stream that is far from its base level. River incision is common after tectonic uplift of the landscape. Incision by multiple rivers result in a dissected landscape, for example a dissected plateau. River Incision is the natural process by which a river cuts downward into its bed, deepening the active channel. Though it is a natural process, it can be accelerated rapidly by human factors including land use changes such as timber harvest, mining, agriculture, and road and dam construction. The rate of incision is a function