Tympanostomy tubes
EBM Guidelines
Apr 11, 2024 • Completely updated
Table of contents
Extract
- The most common indications for insertion of tympanostomy tubes (ventilation tubes, grommets) are persistent middle ear fluid (over 3 months) Otitis media with effusion (glue ear)1, and recurrent acute otitis media (AOM) Toistuvat äkilliset välikorvatulehdukset ja niiden ehkäisy2 .
- Insertion of tympanostomy tube cures the hearing loss caused by middle ear fluid.
- The insertion of tympanostomy tubes will probably not reduce the frequency of recurrent
AOM but may relieve symptoms of inflammation and make it easier to diagnose infections.
- Tympanostomy tubes are most beneficial for children in whom middle ear fluid does not clear between recurrent AOM episodes.
- Problems associated with tympanostomy tubes may include inflammation and otorrhoea due to the tube, a blocked tube or persistent tympanic membrane perforation.
- During an AOM episode, an ear with a tympanostomy tube will leak fluid (otorrhoea). In such a case, the primary treatment is ear drops.
- If an open tube does not leak fluid, there is no middle ear infection, even if the tympanic membrane appears abnormal.
Linked evidence summaries
- Grommets (ventilation tubes) offer a small short-term hearing improvement in children with simple glue ear (otitis media with effusion, OME). No effect on speech and language development has been proven.A
- Antibiotic eardrops (with or without corticosteroid) appear to be more effective than oral antibiotics in children with ear discharge occurring at least two weeks following grommet insertion.B
- Oral antibiotics may hasten the resolution of otorrhoea associated with grommets compared to placebo or no intervention.C
Search terms
AOM, Bacterial culture, Child, Children, Discharging tympanostomy tube, Ear, Ear canal, Ear drops, Ear with tympanostomy tube, H66*, H92.1, Middle ear ventilation, Middle ear ventilation, Normal flora, OME, Otitis, Otitis media, Otitis media, Otitis media with effusion, Otitis media with effusion, Otorhinolaryngology, Paediatric otitis media, Paediatrics, Prednisolone, Pseudomonas, Systemic glucocorticoid therapy, Tympanic membrane, Tympanoplasty, Tympanosclerosis, Tympanostomy tubes