Otolaryngology Book


Tympanostomy Tube

Aka: Tympanostomy Tube, Pressure Equalization Tube, Tympanostomy, Myringotomy, PE Tube, Antibiotic Drops Via Patent Tympanostomy Tube
  1. Indications: Tympanostomy Tube for age 6 months to 12 years
    1. Bilateral otitits media with effusion for 3 months or more with documented Hearing Deficit (>25 decibels)
    2. Refractory Otitis Media
    3. Recurrent Otitis Media and persistent effusion at evaluation for Tympanostomy Tube placement
      1. Three or more episodes in 6 months or
      2. Four or more episodes in 1 year (with at least one episode in last 6 months)
  2. Efficacy: Persistent Serous Otitis
    1. Hearing improves in short-term, but no longterm benefit
    2. At 12-24 months, Hearing same as with watchful waiting
      1. Rovers (2005) Arch Dis Child 90:480-5 [PubMed]
      2. Steele (2017) Pediatrics 139(6): e20170125 [PubMed]
  3. Adverse Effects
    1. Long-term Tympanic Membrane structural abnormalities
      1. Associated with focal atrophy, Tympanosclerosis, retraction pockets, chronic perforation or Otorrhea, Cholesteatoma
      2. May result in longterm reduced Hearing
      3. Stenstrom (2005) Arch Pediatr Adolesc Med 159(12): 1151-6 [PubMed]
  4. Management: Otitis Media with patent Tympanostomy Tubes
    1. Only Topical Antibiotics are needed if Tympanostomy Tubes are patent
    2. For maximal penetration
      1. See Ear Canal Instillation
      2. Clear visible debris from ear canal
      3. Pull tragus back and down several times after instilling drops
    3. Topical, non-ototoxic antibiotic options
      1. Do not use Cipro HC Otic (not sterile)
      2. Avoid all cortisporin products (including suspension)
      3. Combinations with steroid result in faster resolution but are much more expensive
      4. Ofloxacin 0.3% (Floxin Otic) 5 drops (10 drops if over age 12) twice daily for 7 days
      5. Ciprofloxacin ophthalmic (ciloxan drops) 4 drops twice daily for 7 days
      6. Ciprofloxacin 0.3% with Dexamethasone 0.1% (Ciprodex) 4 drops in ear twice daily for 7-10 days
      7. Ciprofloxacin 0.3% with Fluocinolone Acetonide 0.025% (Otovel) 0.25 ml vial in ear twice daily for 7 days
    4. References
      1. Schmelzle (2008) Can Fam Physician 54(8): 1123–7 [PubMed]
  5. Management: Swimming
    1. Ear plugs, head bands, or swimming avoidance is typically not required for those with Tympanostomy Tubes
    2. However, use ear plugs in the following situations
      1. Head submerged in soapy bath water
      2. Swimming in non-chlorinated water (e.g. lakes, rivers)
      3. Diving deeper than 6 feet
  6. References
    1. (2017) Presc Lett 24(6): 31-2
    2. Harmes (2013) Am Fam Physician 88(7):435-40 [PubMed]
    3. Rosenfeld (2013) Otolaryngol Head Neck Surg 149(1 suppl): S1-35 [PubMed]

Tympanostomy (C0087123)

Definition (NCI) Surgical incision into the eardrum.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D008876
ICD9 20.0
ICD10 309
SnomedCT 148932003, 23354000, 265049001, 172677000, 397862008, 397760009
English Tympanostomies, Middle ear paracentesis, myringotomy (treatment), myringotomy, Incision of Eardrum, Tympanostomy, tympanocentesis, tympanostomy, tympanotomy, myringotomies, Tympanic memb. operat., Grommet procedure ear, Myringotomy (procedure), Myringotomy, Tympanotomy, Myringostomy, Tympanostomy (procedure), Tympanotomy (procedure)
Italian Miringotomia, Timpanostomia, Drenaggio trans-timpanico
Japanese 鼓膜切開, コマクセッカイ
Czech Myringotomie
French Myringotomie, Tympanostomie, Tympanotomie, Myringostomie
Hungarian Myringotomia
Norwegian Tympanostomi
Spanish miringostomía, miringotomía, timpanostomía (procedimiento), timpanostomía, timpanotomía (procedimiento), timpanotomía, Miringotomía
Portuguese Miringotomia
Dutch myringotomie
German Myringotomie
Derived from the NIH UMLS (Unified Medical Language System)

You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree