Tympanostomy tube

The grommet is less than 2 mm tall, smaller than a match head.

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Tubes of a more permanent style, unlike those typically used in the United States. These tubes remained in place for four years until one spontaneously left the ear drum. The other was removed with tweezers after having partially disengaged from the ear drum. The removal process can cause significant pain for several minutes.

Tympanostomy, a prevalent surgical procedure, especially among children, involves the insertion of a tympanostomy tube into the eardrum. This tube ensures aeration of the middle ear over extended durations and prevents fluid accumulation within.

Overview of Tympanostomy Tubes

A tympanostomy tube is more commonly known by various names including:

• Grommet
• T-tube
• Ear tube
• Pressure equalization tube
• Vent
• PE tube
• Myringotomy tube

The procedure to implant the tube requires a myringotomy, executed under either local or general anesthesia. The design of these tubes varies, with the grommet shape being the most prevalent. For cases demanding extended middle ear ventilation, the "T"-shaped tube is favored due to its longevity, typically remaining in place for 2-4 years. The materials frequently utilized for these tubes are plastics, such as silicone or Teflon. Although stainless steel tubes were once common, their use has dwindled in recent times.

Indications for Tympanostomy

While certain long-term studies have challenged the routine execution of ear tube surgeries, contemporary guidelines set for American otolaryngologists recommend tube placement under the ensuing conditions:

• Chronic otitis media with unceasing effusion lasting 6 months (in one ear) or 3 months (in both ears).
• Recurrent acute otitis media documented as 3 infections within 6 months or 4 infections within a year.
• Ongoing eustachian tube dysfunction.

Barotrauma, particularly to circumvent recurrent episodes, which can follow situations like air travel or hypobaric chamber treatment.

Procedure Details

Despite the feasibility of conducting myringotomy with tube insertion under local anesthesia for compliant adults, the primary demographic for this procedure is often young children. As there exists a potential for ear damage if a patient moves during the operation, those anticipated to have difficulties staying still usually undergo the procedure under general anesthesia.

Remarkably, tympanostomy tube implantation is among the most common surgeries executed on children. In the USA, it stands as the predominant reason a child is administered a general anesthetic[3].

Outcomes and Complications

Typically, tympanostomy tubes stay lodged within the eardrum for a span ranging from six months up to two years. T-tubes, due to their design, can last up to four years. Over time, the tubes usually fall out spontaneously owing to the slow outward migration of the eardrum's skin. In most instances, the eardrum heals without leaving a hole at the former tube site. However, in rare cases, a persistent perforation might occur. A prevailing clinical debate pertains to whether tubes intended for longer durations lead to higher incidences of adverse outcomes, such as persistent perforation, cholesteatoma, tympanosclerosis, and others, in contrast to their shorter-duration counterparts.

One of the more common complications post-tympanostomy is otorrhea, a discharge emanating from the ear[4]. Utilizing oral antibiotics is generally not advised for treating uncomplicated acute tympanostomy tube otorrhea[4], as they don't adequately target the causative bacteria and can introduce significant side effects, including an elevated risk of opportunistic infections[4]. In contrast, topical antibiotic eardrops serve as an effective treatment for this condition[4].

See also

• Otitis media

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