Ideal site for myringotomy and grommet insertion-

Incision sites for myringotomy Two common incision sites are used :- i)       Anterior-inferior quadrant Also known as anterior myringotomy Used in cases of serous otitis media when grommet is to be inserted ii)      Postero-inferior quadrant Also known as posterior myringotomy Used in cases of ASOM This area is preferred because this is the most accessible area, relative less vascular and there are less chances of damage to ossicular chain. Now the question arises, If the posterior - inferior quadrant is more accessible and less vascular, why the grommet tube is inserted through anterior-inferior incision? The answer is:- "Grommet inserted through posterior myringotomy incision may cause incus necrosis from the pressure on long process and may damage incudostapedial joint or round window. Therefore, anterior or inferior insertion is safer". — Pediatric otolaryngology