Tympanostomy tube insertion

Last revised by Yahya Baba on 2 Aug 2021

Tympanostomy tube insertion is a surgical procedure in which a tiny tube is inserted in the tympanic membrane, to bypass Eustachian tube dysfunction and to relieve persistent middle ear effusion.

Tympanostomy tube insertion is the most frequent pediatric ambulatory surgery performed in the USA 1.
Around 667 000 children under 15 years are treated with tympanostomy tubes each year 1.

Tubes are inserted usually in the anterosuperior quadrant of the tympanic membrane, under local or general anesthesia 2.
Placement in the anteroinferior quadrant is not recommended, to avoid injuries of the round window 2.

  • chronic otitis media with effusion for more than 3 months 1
  • middle ear effusion with recurrent acute otitis media 1
  • one episode of otitis media with effusion resolving in less than three months 1
  • no middle ear effusion even with recurrent acute otitis media 1

Armstrong performed in 1954 the first tympanostomy tube insertion, using plastic vinyl tubes, in five patients 2.

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Cases and figures

  • Case 1: bilateral
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  • Case 2
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  • Case 3
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