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Overview of tympanostomy tube placement, postoperative care, and complications in children

Glenn C Isaacson, MD, FAAP
Section Editor
Anna H Messner, MD
Deputy Editor
Carrie Armsby, MD, MPH


Tympanostomy tube insertion is among the most common operative procedures in childhood [1,2]. As such, tympanostomy tube surgery has considerable impact on the health of young children and upon medical economics.

An overview of tympanostomy tubes, the postoperative care of the child with tympanostomy tubes, and the diagnosis and management of complications of tympanostomy tubes in children are reviewed here. The indications for, and efficacy of, tympanostomy tubes in children with otitis media with effusion (OME) and recurrent acute otitis media (AOM) are discussed separately. The prevention and management of tympanostomy tube otorrhea is also reviewed in detail separately. (See "Otitis media with effusion (serous otitis media) in children: Clinical features and diagnosis" and "Acute otitis media in children: Prevention of recurrence" and "Tympanostomy tube otorrhea in children: Causes, prevention, and management" and "Otitis media with effusion (serous otitis media) in children: Management".)


In the United States in 2006, 667,000 children less than 15 years of age underwent surgery for insertion of tympanostomy tubes [1]. Tympanostomy tube insertion rates are high in other developed countries as well. In Denmark, approximately 30 percent of children undergo at least one ventilation tube insertion by their fifth birthday [3].

The rate of tympanostomy tube placement is higher in children who attend daycare. Children with autism spectrum disorder and/or developmental delay also undergo tube insertion at a higher rate, possibly because of a lower threshold to perform the surgery in children at greater risk for speech delay or protracted ear difficulties [4]. In addition, children with craniofacial anomalies, such as cleft palate or trisomy 21, are more likely to have dysfunction of the eustachian tube leading to the development of otitis media, with a subsequent increased risk for tympanostomy tube placement [5]. (See "Autism spectrum disorder: Clinical features", section on 'Language impairment' and "Eustachian tube dysfunction".)

The frequency of tympanostomy tube insertion in young children in the United States has declined since the introduction of the pneumococcal conjugate vaccine into the routine childhood immunization schedule in 2000. (See "Acute otitis media in children: Prevention of recurrence", section on 'Pneumococcal conjugate vaccine'.)

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Literature review current through: Nov 2017. | This topic last updated: Sep 06, 2017.
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