Tympanostomy tube

File:Grommet.gif

A tympanostomy tube (also known as a grommet or ear tube) is a small tube inserted into the eardrum in order to keep the middle ear aerated for a prolonged period of time, and to prevent the accumulation of mucus in the middle ear. The operation to insert the tube involves a myringotomy. The tube itself is made in a variety of designs. The most commonly used type is shaped like a grommet or T. When it is necessary to keep the middle ear ventilated for a very long period, a "T"-shaped tube may be used. Materials used to construct the tube are most often plastics such as silicone or Teflon. Stainless steel tubes exist, but are no longer in frequent use.

Although myringotomy with tube insertion can be performed under local anesthesia during a regular doctor's appointment in co-operative adults, patients requiring tube insertion are very often young children. Since damage to the ear is possible unless the patient stays quite still while being manipulated, for any patient who may have difficulty lying still during the procedure, myringotomy and tube insertion is performed under a brief general anesthesia.

The insertion of tympanostomy tubes is one of the most common surgical procedures performed on children. In the USA, it is the most common reason for a child to undergo a general anaesthetic. T-Tubes can last up to 5 years or more. When the tubes are released from the ear, it is usually covered in a mini- goiter of wax. Nausea and vomiting is very common when the tubes fall out. (Due to equilibrium that may need to pressurize the balance of the ear) It may last for up to 48 hours on some occasions.

Tympanostomy tubes generally remain in the eardrum for some period of time, ranging from 2 years to 5 years, before spontaneously falling out of the eardrum. The eardrum usually (but not always) closes without a residual hole at the tube site.

Tubes of a style more permanent than typically used in the United States. These tubes remained in place for 4 years until one spontaneously left ear drum, and the other was removed with tweezers after having partially disengaged from ear drum. There was significant pain for 3-5 minutes, during removal of the second tube. Note that these tubes are designed to stay in the ear drum for multiple seasons, compared to the ones shown above with smaller flanges.

Long term studies have called the necessity of routine ear tube surgery into question.

See also

• Otitis media