A tympanostomy tube (also known as a grommet, ear tube, pressure equalization tube, vent, PE tube or myringotomy 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 fluid in the middle ear. The operation to insert the tube involves a myringotomy and is performed under local or general anesthesia. The tube itself is made in a variety of designs. The most commonly used type is shaped like a grommet. When it is necessary to keep the middle ear ventilated for a very long period, a "T"-shaped tube may be used, as these "T-tubes" can stay in place for 2-4 years. 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, any patient who may have difficulty lying still during the procedure undergoes myringotomy and tube insertion under 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.
Tympanostomy tubes generally remain in the eardrum for 6 months to 2 years, with T-tubes lasting up to 4 years. They generally spontaneously fall out of the eardrum as the skin of the eardrum slowly migrates out towards the ear canal wall over time. The eardrum usually closes without a residual hole at the tube site but in a small number of cases a perforation can persist.
Long term studies have called the necessity of routine ear tube surgery into question, but current guidelines for American otolaryngologists indicate tube placement in the following conditions:
- Chronic otitis media with persistent effusion for 6 months (one ear) or 3 months (both ears).
- Recurrent acute otitis media: 3 ear infections in 6 months or 4 infections in a year.
- Persistent eustachian tube dysfunction
- Barotrauma: Especially for prevention of recurrent episodes (e.g., after air travel, hypobaric chamber treatment).
Famous quotes containing the word tube:
“One of the great natural phenomena is the way in which a tube of toothpaste suddenly empties itself when it hears that you are planning a trip, so that when you come to pack it is just a twisted shell of its former self, with not even a cubic millimeter left to be squeezed out.”
—Robert Benchley (1889–1945)