Tympanostomie

Tympanostomie, or tympanostomy tube insertion, is a surgical procedure in which a small ventilation tube is inserted through the tympanic membrane (eardrum) to aerate the middle ear and prevent the accumulation of fluids. The tubes, also called grommets, remain in place for several months and help normalize ear pressure and hearing.

Indications include chronic otitis media with effusion lasting more than three months and causing conductive hearing loss, or recurrent acute otitis media defined as three or more episodes in six months or four in a year with persistent effusion. In children, adenoidal hypertrophy or other nasal factors may contribute to middle-ear fluid, and adenoidectomy may be considered alongside tympanostomy.

Contraindications are uncommon but may include active infection at the time of surgery or certain middle-ear conditions that require alternative management. Evaluation typically involves ENT assessment and audiometry; the procedure is more common in children, though adults may also benefit in selected cases.

Procedure details: the operation is usually performed under general anesthesia in children. A brief incision is made in the tympanic membrane, and a small hollow tube is placed to ventilate the middle ear. The operation is short, often completed in 10 to 20 minutes. Tubes can be short-term or longer-lasting, depending on the device.

Postoperative care and outcomes: patients are advised to protect the ears from water and monitor for drainage. Hearing often improves after fluid clearance, and many children experience reduced frequency of ear infections. Tubes typically extrude spontaneously as the tympanic membrane heals.

Complications are uncommon but may include otorrhea, persistent perforation after extrusion, tube blockage, tympanosclerosis, or rarely cholesteatoma. Overall, tympanostomy tubes are a well-established, effective treatment for appropriately selected patients.