2
Key Points
➤ Insertion of tympanostomy tubes is the most common ambulatory
surgery performed on children in the United States.
➤ Tympanostomy tubes are most often inserted because of persistent
middle ear fluid, frequent ear infections, or ear infections that persist
after antibiotic therapy.
• All these conditions are encompassed by the term otitis media (middle ear
inflammation), which is second in frequency only to acute upper respiratory
infection (URI) as the most common illness diagnosed in children by health care
professionals.
➤ When children receive surgery for OME (Table 1), insertion of
tympanostomy tubes is the preferred initial procedure, with
candidacy dependent primarily on hearing status, associated
symptoms, and the child's developmental risk.
➤ Risks and potential adverse events of tympanostomy tube insertion
are related to both general anesthesia, usually required for the
procedure, and the effects of the tympanostomy tube on the tympanic
membrane and middle ear.
➤ When making clinical decisions, the risks of tube insertion must be
balanced against the risks of chronic OME, recurrent otitis media, or
both conditions, which include suppurative complications, damage to
the tympanic membrane, adverse effects of antibiotics, and potential
developmental sequelae of the mild to moderate hearing loss that is
often associated with middle ear effusion.
Table 1. Abbreviations and Definitions of Common Terms
Term Definition
Myringotomy A surgical procedure in which an incision is made in the tympanic
membrane for the purpose of draining fluid from the middle ear
space or providing short-term ventilation.
Tympanostomy
tube insertion
Surgical placement of a tube through a myringotomy incision for
purposes of temporary middle ear ventilation. Tympanostomy
tubes generally last several months to several years, depending on
tube design and placement location in the tympanic membrane.
Synonyms include ventilation tubes, pressure equalization (PE)
tubes, grommets (UK), and bilateral myringotomy and tubes
(BMT).
Otitis media with
effusion (OME)
e presence of fluid in the middle ear without signs or symptoms
of acute otitis media (AOM).
Chronic OME OME persisting for 3 months or longer from the date of onset (if
known) or from the date of diagnosis (if onset unknown).
