Does myringotomy suffice to maintain a patent tympanic membrane perforation throughout hyperbaric oxygen therapy?

Objective To determine whether myringotomy suffices to maintain a tympanic membrane perforation (TMP) or if a tympanostomy tube is required throughout a course of hyperbaric oxygen therapy (HBOT). Study design Animal model blinded study. Setting Animal facility of a tertiary medical center. Animals and methods Bilateral myringotomies were performed on 14 C57BL/6J mice who were randomly assigned to experimental and control groups of 7 mice each. All of the experimental mice underwent daily HBOT delivered at 2.8 technical atmosphere units (ATA) for 90 min. Otoscopy was performed daily by a single researcher who was blind to group assignment and who assessed spontaneous TMP closure until day 8 following the myringotomy. Results All of the TMPs in the experimental group had closed spontaneously during days 1–5. Their TMP closure rate was more rapid than that of the control animals, with a cumulative TMP survival of 0.0 vs. 0.1429, respectively, at day 8 ( P < 0.0001). Conclusion Myringotomy does not suffice to ensure the maintenance of a patent TMP throughout HBOT. A tympanostomy tube is therefore necessary to secure pressure equalization in patients with eustachian tube dysfunction who are candidates for HBOT for any reason.