The pressure of fluid in an infected middle ear onto the eardrum may cause it to rupture. Usually this consists of a small hole (perforation), which allows fluid to drain out. If this does not occur naturally, a myringotomy (tympanotomy, tympanostomy) can be performed. A myringotomy is a surgical procedure in which a tiny incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. The fluid or pus comes from a middle ear infection (otitis media), which is a common problem in children. A tympanostomy tube is inserted into the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously in two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure.