Tympanostomietubes

Tympanostomietubes (tympanostomy tubes) are small cylindrical devices inserted through the tympanic membrane to ventilate the middle ear and drain fluid. They are commonly called tympanostomy tubes, ear tubes, or grommets.

They are used in children with recurrent acute otitis media or chronic otitis media with effusion resulting in persistent fluid and conductive hearing loss. Typical criteria include multiple AOM episodes in six months or a year, or persistent effusion with hearing loss or speech delay. They may also be considered in cases of barotrauma or when effusion persists despite other treatments.

The tubes come in several materials, including silicone, fluoroplastic, and titanium. Designs vary between short-term and longer-lasting versions, with differences in flange and ventilation features. They allow air to circulate in the middle ear and enable drainage of fluid while the eardrum heals.

The procedure is usually performed under general anesthesia in children and is commonly done on an outpatient basis. A small incision is made in the tympanic membrane (myringotomy) and the tube is inserted. In some cases, adenoidectomy may be performed if adenoids contribute to middle-ear problems.

Most tubes remain in place for about 6 months to 2 years and extrude spontaneously. They provide ongoing ventilation, reduce fluid buildup and frequency of infections, and often improve hearing and language development in affected children.

Potential complications include otorrhea through the tube, tube blockage, tympanic membrane perforation after extrusion, scarring, and rarely cholesteatoma or persistent conductive problems. Most issues are mild and treatable. Regular follow-up with ear examinations and audiometry is recommended.