Tympanostomy Tube – July 20, 2023
A 45-year-old male with a history of middle ear infections presents to the ENT clinic for a follow-up appointment. He had a ventilation tube placed 12 months ago. He has no current concerns.
What do you notice that is unique about the tympanostomy tube in this image taken with the WiscMed Wispr digital otoscope?
This is a “long term” tympanostomy tube and may be occluded.
Tympanostomy (ventilation, ear) tubes are placed to drain fluid from the middle ear space. Commonly this is done for children that have recurrent acute otitis media. Adults generally don’t get middle ear infections because their eustachian tubes drain more vertically to the posterior nasopharynx. In this case, the patient appears to have had a long history of middle ear infections as the tympanic membrane appears sclerosed. This ventilation tube is interesting because it is a long-term tube; the tube is longer and it does not have an external flange. Both of these features help to prevent the extrusion of the tube. Compare this long-term tube with a more typical pediatric tube. Note the external flange on the short-term tube.
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- Long-Term Ventilation Tube
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- Short-Term Ventilation Tube
This tube also appears to be occluded. If the tube is blocked, ventilation of the middle ear space is not occurring. This suggests that the tube either needs to be replaced or an attempt should be made to unblock the tube.
Here is the complete video exam:
