Nov 20, 2007
desertgirl in the ENT forum had questions about tympanostomy tube placement and I wanted to give an overview here:
Placement of tympanostomy tubes allows ventilation of the middle ear, circumventing the poorly functioning eustachian tube which otherwise drains fluid away.
Tympanostomy tubes are indicated when long-term ventilation of the middle ear space is desired with Otitis media with effusion
ENT follow-up after tympanostomy tube placement often is necessary at four- to six-month intervals. ENT follow-up continues until at least one year after extrusion or removal of tubes and healing of the TM, normal eustachian tube function, and normal hearing have been established.
Referral to the otolaryngologist earlier than regularly scheduled follow-up may be necessary for:
- Chronic, recurrent, or bloody otorrhea (ear drainage)
- Persistent ear pain, worsening hearing, or balance issues.
- Suspected structural disease of the tympanic membrane.
- If the tube is obstructed and causing pain, or cannot be visualized.
– An extruded tube (fell out) that cannot be removed from the ear canal.
- A tube that has migrated into the middle ear space.
- The tube has been retained for more than two years.
A tympanostomy tube is working if it spans the eardrum, its lumen is unobstructed, and no middle ear effusion is present
Complications of tympanostomy tubes include persistent perforation of the tympanic membrane (permanent hole), tube obstruction, tympanosclerosis, focal atrophy of the tympanic membrane, and cholesteatoma.