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
Joel-Cohen incision for re-appearance of audible intestinal sounds were shorter in Joel-Cohen group than the Pfannenstiel group in a study conducted with 153 women. In the two studies (with 411 participants) that compared the Joel-Cohen incision with the Pfannenstiel incision, the Joel-Cohen incision was associated with a 65% reduction in postoperative febrile morbidity. The skin incision is made 3 cm above the location of Pfannenstiel incision. The subcutaneous tissue is incised in three medial centimetres. The lateral tissue separation is done manually and the fascia is divided by blunt dissection using both index fingers. This incision is extended laterally by the fingers.