A tympanostomy tube is a tube which is inserted into the ear drum, also known as the tympanic membrane, in order to maintain a small hole. The hole aerates the ear drum and provides an outlet for fluid drainage. Such tubes are inserted in patients who have experienced chronic ear infections or buildups of fluid in their ears. Most commonly, a tympanostomy tube insertion is recommended for children who experience recurrent ear problems, although these tubes can also be placed in adults.
Tympanostomy tube placement starts with a myringectomy, in which a small incision is made in the ear drum. Commonly, fluid has built up, and the surgeon gently suctions it out before placing the tube. Tympanostomy tubes will stay in for two to five years before naturally falling out, although in some cases surgical removal may be required. Tubes with specialized flanges can be inserted to ensure that the tube stays in the ear longer. The surgical site heals very quickly, usually within days, because the ear drum is designed to repair itself as quickly as possible when it is damaged.
It is necessary to hold completely still during the procedure, as movement from the patient could cause the surgeon to slip and damage the patient's ear. In patients who are capable of understanding the need to hold still, a local anesthetic will be used. In patients who lack the ability to hold still or do not have the mental capacity to understand the need to be still, a general anesthetic is used for safety.
The material used for the tubes, also known as grommets, varies. Historically, metal was a common choice, but today surgical plastics are more common, as metal has been linked with more infections. While a tympanostomy tube is in, a doctor will usually periodically check on the patient's ears to confirm that the tube is still in place and not causing any problems. One advantage to the tube is that if the patient does experience an infection, the fluid drains from the tube and can easily be collected and cultured to find out what is causing the infection.
When a tympanostomy tube procedure is recommended for a child, if the child is old enough, it is a good idea to talk about the procedure before it happens. The surgeon can go over the procedure with the child, or the child's parents can provide information. Knowing what to expect and understanding that the procedure will not be painful can reduce anxiety about the surgery. Less anxiety tends to reduce the risk of surgical complications and decreases the healing time after surgery.
