June 06, 2015

Types of Ear Tubes

Ear tubes are placed whenever adequate ventilation of the middle ear is compromised and unresponsive to medications. Such situations include chronic ear infections, eustachian tube dysfunction, hearing loss due to fluid, etc. Once the decision is made to place an ear tube, the surgeon has many choices of ear tubes that could be placed.

There are three main "classes" of ear tubes: grommet tubes (A), intermediate tubes (B), and T-tubes (C).

When selecting what class of tube to place, the dilemma the surgeon faces is that the longer ventilation period provided by the more "permanent" T tube (C) is offset by the increased complication rates (eg, eardrum hole, eardrum scarring, chronic ear drainage). Alternatively, the lower complication rates of shorter-lasting grommet-type tube (A) is offset by the overall shorter period of ventilation which may then lead to repeat surgeries for persistent ear problems. Intermediate tubes (C) tries to compromise somewhere in between grommet and T-tubes both in duration as well as complications.

Complication Rate
Short (about 1 year)
Intermediate (a few years)
Long (~10 years)

Keep in mind that regardless of the class, tubes overall are VERY small and what principally affects duration and complication rates are the tube design rather than size in of itself.

Most surgeons initially place grommet style tubes in a patient who has never had tubes before or rarely requires them given the very low complication rates.

For patients who have required many grommet tubes or find that such tubes last only a few months before falling out, intermediate or T-tubes may be considered.

Within each class, the tubes also come in different sizes (mainly changes in the diameter of the opening), colors, and materials.

Materials the tubes are made of include (in rank order from most to least common):

• Fluoroplastic
• Silastic
• Titanium
• Teflon
• Stainless steel

Depending on the skill of the surgeon, such tubes can be placed in the clinic without any sedation or in the operating room under anesthesia.

Watch a video of how ear tubes are placed!

Here's a video showing how to use ear drops properly for maximal effectiveness, even if lots of drainage present.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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