• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

When Should a Retained Tympanostomy Tube Be Removed?

by Alahni Becks, BSc, Bing M. Teh, MBBS, PhD, and Anil K. Lalwani, MD • January 14, 2022

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

TRIO Best PracticeTRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.

You Might Also Like

  • Is There an Optimal Location for Tympanostomy Tube Placement?
  • Single Visit Surgery an Appealing Option for Tympanostomy Tube Placement in Children with Recurrent Acute Otitis Media
  • Are Water Precautions Necessary After Tympanostomy Tube Placement?
  • What is the Role of Tympanostomy Tubes in the Treatment of Recurrent Acute Otitis Media?
Explore This Issue
January 2022

Background

Placement of tympanostomy tubes is one of the most common ambulatory procedures performed in the pediatric population. Tympanostomy tube placement has been shown to significantly improve speech and hearing, as well as reduce the rates of effusion and recurrent acute otitis media (AOM). The main indications of tympanostomy tube are recurrent AOM with middle ear effusion, chronic otitis media with effusion (OME), and Eustachian tube dysfunction. The majority of tympanostomy tubes self-extrude within six to 18 months due to the natural epithelial migration of tympanic membrane (TM); tubes that fail to spontaneously extrude for more than two years are considered retained and may require manual removal in office or in the operating theatre under general anesthesia.

© Dr P. Marazzi / Science Source

© Dr P. Marazzi / Science Source

Currently, there are no guidelines for the management of retained tubes in asymptomatic patients. Should they be removed? If so, when? Hence, the purpose of this Triological Best Practice is to examine the current best evidence to determine when a retained tympanostomy tube should be removed in children.

Best Practice

Management of retained ventilation tube has to balance the risks of a recurrent OME requiring repeat tube placement against complications associated with prolonged tube retention (such as TM perforation, chronic suppurative otitis media, cholesteatoma, and displacement of the tube into the middle ear). Based on current literature, asymptomatic retained tubes in children under the ages of 7 to 8 years may remain in place to avoid recurrent OME until such times that complications occur, when the intubation period exceeds 18 months, or when the patient reaches 7 to 8 years of age; in children over the age of 7 to 8 years, removal of an asymptomatic retained tympanostomy tube may be considered after 18 months to reduce the risks of complication associated with a retained tympanostomy tube. Further prospective studies are needed to better define the management of retained ventilation tubes.

Filed Under: Pediatric, Pediatric, TRIO Best Practices Tagged With: clinical research, treatment, tympanostomy tubeIssue: January 2022

You Might Also Like:

  • Is There an Optimal Location for Tympanostomy Tube Placement?
  • Single Visit Surgery an Appealing Option for Tympanostomy Tube Placement in Children with Recurrent Acute Otitis Media
  • Are Water Precautions Necessary After Tympanostomy Tube Placement?
  • What is the Role of Tympanostomy Tubes in the Treatment of Recurrent Acute Otitis Media?

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Have you invented or patented something that betters the field of otolaryngology?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • Otolaryngologists as Entrepreneurs: Transforming Patient Care And Practice

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Physician Handwriting: A Potentially Powerful Healing Tool

    • Continued Discussion And Engagement Are Essential To How Otolaryngologists Are Championing DEI Initiatives In Medicine

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • Physician Handwriting: A Potentially Powerful Healing Tool
    • Leaky Pipes—Time to Focus on Our Foundations
    • You Are Among Friends: The Value Of Being In A Group
    • How To: Full Endoscopic Procedures of Total Parotidectomy
    • How To: Does Intralesional Steroid Injection Effectively Mitigate Vocal Fold Scarring in a Rabbit Model?

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939