WordNet

ride or float on an inflated tube; "We tubed down the river on a hot summer day"
conduit consisting of a long hollow object (usually cylindrical) used to hold and conduct objects or liquids or gases (同)tubing
electronic device consisting of a system of electrodes arranged in an evacuated glass or metal envelope (同)vacuum_tube, thermionic vacuum tube, thermionic_tube, electron_tube, thermionic_valve
(anatomy) any hollow cylindrical body structure (同)tube-shaped structure
convey in a tube; "inside Paris, they used to tube mail"
place or enclose in a tube
provide with a tube or insert a tube into
the amount that a tub will hold; "a tub of water" (同)tubful
a large open vessel for holding or storing liquids (同)vat
of a tire; having an inner tube

PrepTutorEJDIC

(金属・ガラス・ゴムなどの)管,筒 / (絵の具・歯みがきなどの)チューブ / 《米》(列車・地下鉄の)トンネル / 《英》地下鉄(《米》subway) / (ラジオ・テレビなどの)真空管(vacuum tube) / (動植物の)管状器官
『おけ』,たらい / 《話》'bath 2 / (また tubful)おけ1杯[の量](の…)《+of+名》 / 《話》のろくてぶかっこうな船;《俗》でぶ,太っちょ
〈U〉管状の物 / 《集合的に》管類 / 〈C〉(ある長さの1本の)管

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/19 21:53:01」(JST)

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The grommet is less than 2 mm tall, smaller than a match head.

Tubes of a more permanent style, unlike those typically used in the United States. These tubes remained in place for four years until one spontaneously left the ear drum. The other was removed with tweezers after having partially disengaged from the ear drum. The removal process can cause significant pain for several minutes.

A tympanostomy tube (also known as a grommet, T-tube, ear tube, pressure equalization tube, vent, PE tube or myringotomy tube) is a small tube inserted into the eardrum in order to keep the middle ear aerated for a prolonged period of time, and to prevent the accumulation of fluid in the middle ear. The operation to insert the tube involves a myringotomy and is performed under local or general anesthesia. The tube itself is made in a variety of designs. The most commonly used type is shaped like a grommet. When it is necessary to keep the middle ear ventilated for a very long period, a "T"-shaped tube may be used, as these "T-tubes" can stay in place for 2-4 years. Materials used to construct the tube are most often plastics such as silicone or Teflon. Stainless steel tubes exist, but are no longer in frequent use.

Indications

Guidelines state that tubes are an option in:

Recurrent acute otitis media: 3 ear infections in 6 months or 4 infections in a year.^[1] The evidence for this recommendation; however, is weak.^[1]
Chronic otitis media with persistent effusion for 6 months (one ear) or 3 months (both ears).^{[citation needed]}
Persistent eustachian tube dysfunction^{[citation needed]}
Barotrauma: Especially for prevention of recurrent episodes (e.g., after air travel, hyperbaric chamber treatment).^{[citation needed]}

Procedure

Ear tube

Although myringotomy with tube insertion can be performed under local anesthesia during a regular doctor's appointment in co-operative adults, patients requiring tube insertion are very often young children. Since damage to the ear is possible unless the patient stays quite still while being manipulated, any patient who may have difficulty lying still during the procedure typically undergoes myringotomy and tube insertion under general anesthesia.

The insertion of tympanostomy tubes is one of the most common surgical procedures performed on children. In the United States, it is the most common reason for a child to undergo a general anaesthetic.^[2]

Outcome

Tympanostomy tubes generally remain in the eardrum for six months to two years, with T-tubes lasting up to four years. They generally spontaneously fall out of the eardrum as the skin of the eardrum slowly migrates out towards the ear canal wall over time. The eardrum usually closes without a residual hole at the tube site but in a small number of cases a perforation can persist. There is debate among clinicians as to whether long-lasting tubes are associated with a higher incidence of adverse outcomes, such as persistent perforation, cholesteatoma, tympanosclerosis and others, as opposed to tubes designed to last for shorter durations.

A common complication of getting a tympanostomy tube is experiencing otorrhea, which is a discharge from the ear.^[3] Oral antibiotics should not be used to treat uncomplicated acute tympanostomy tube otorrhea.^[3] Oral antibiotics are not a sufficient response to bacteria which cause this condition and have significant side effects including increased risk of opportunistic infection.^[3] In contrast, topical antibiotic eardrops can treat this condition.^[3]

References

^ ^a ^b Lieberthal, AS; Carroll, AE; Chonmaitree, T; Ganiats, TG; Hoberman, A; Jackson, MA; Joffe, MD; Miller, DT; Rosenfeld, RM; Sevilla, XD; Schwartz, RH; Thomas, PA; Tunkel, DE (March 2013). "The diagnosis and management of acute otitis media.". Pediatrics 131 (3): e964–99. PMID 23439909.
^ Vaile L. Williamson T. Waddell A. Taylor G. Interventions for ear discharge associated with grommets (ventilation tubes)
^ ^a ^b ^c ^d American Academy of Otolaryngology – Head and Neck Surgery, "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation (American Academy of Otolaryngology – Head and Neck Surgery), retrieved August 1, 2013 , which cites
- Rosenfeld, R. M.; Schwartz, S. R.; Pynnonen, M. A.; Tunkel, D. E.; Hussey, H. M.; Fichera, J. S.; Grimes, A. M.; Hackell, J. M.; Harrison, M. F.; Haskell, H.; Haynes, D. S.; Kim, T. W.; Lafreniere, D. C.; LeBlanc, K.; Mackey, W. L.; Netterville, J. L.; Pipan, M. E.; Raol, N. P.; Schellhase, K. G. (2013). "Clinical Practice Guideline: Tympanostomy Tubes in Children". Otolaryngology -- Head and Neck Surgery 149 (1 Suppl): S1–S35. doi:10.1177/0194599813487302. ISSN 0194-5998. PMID 23818543.

UpToDate Contents

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1. 小児に対する中耳腔換気用チューブ留置、術後ケア、および合併症の概要 overview of tympanostomy tube placement postoperative care and complications in children
2. 小児における中耳腔換気用チューブ留置後の耳漏：原因、予防、およびマネージメント tympanostomy tube otorrhea in children causes prevention and management
3. 小児における急性中耳炎：再発予防 acute otitis media in children prevention of recurrence
4. 小児における滲出性（漿液性）中耳炎：マネージメント otitis media with effusion serous otitis media in children management
5. 小児における耳漏（耳だれ）の評価 evaluation of otorrhea ear discharge in children

English Journal

Everolimus-coated tympanostomy tube on rat tympanic membrane.

Akbulut S, Altintaş H, Berk D, Sezen OS, Barisik NO.SourceDepartment of Otolaryngology Head and Neck Surgery, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey. Electronic address: sevtap.akbulut@gmail.com.
International journal of pediatric otorhinolaryngology.Int J Pediatr Otorhinolaryngol.2013 Jul;77(7):1147-51. doi: 10.1016/j.ijporl.2013.04.027. Epub 2013 May 22.
OBJECTIVES: Everolimus is an immunosuppressant and an antiproliferative macrolide agent which is used for coronary stent coating for local inhibition of in-stent restenosis. The aim of this study was to evaluate the effect of everolimus-coated tympanostomy tubes in rat tympanic membrane.STUDY DESIGN
PMID 23707155

Clinical practice guideline: tympanostomy tubes in children.

Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, Hussey HM, Fichera JS, Grimes AM, Hackell JM, Harrison MF, Haskell H, Haynes DS, Kim TW, Lafreniere DC, Leblanc K, Mackey WL, Netterville JL, Pipan ME, Raol NP, Schellhase KG.SourceDepartment of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.Otolaryngol Head Neck Surg.2013 Jul;149(1 Suppl):S1-S35. doi: 10.1177/0194599813487302.
Objective Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. Despite the
PMID 23818543

Clinical practice guideline: tympanostomy tubes in children--executive summary.

Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, Hussey HM, Fichera JS, Grimes AM, Hackell JM, Harrison MF, Haskell H, Haynes DS, Kim TW, Lafreniere DC, Leblanc K, Mackey WL, Netterville JL, Pipan ME, Raol NP, Schellhase KG.SourceDepartment of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.Otolaryngol Head Neck Surg.2013 Jul;149(1):8-16. doi: 10.1177/0194599813490141.
The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the new Clinical Practice Guideline: Tympanostomy Tubes in Children. To assist in implementing the guideline recommendations, this article summarizes the rationale, p
PMID 23818537

Japanese Journal

A Case of Extranodal Non-Hodgkin's Lymphoma in which Otitis Media with Effusion and Combined Hearing Loss Developed as the Initial Symptoms

耳鼻咽喉科臨床　補冊 141(0), 18-19, 2015
NAID 130005077979

滲出性中耳炎で発症したANCA陽性の難治性中耳炎の3例

Otology Japan 24(2), 106-112, 2014
NAID 130005085319

A Study on Ventilation Tube Therapy for Chronic Otitis Media with Effusion in Children

耳鼻咽喉科臨床　補冊 140(0), 18-19, 2014
NAID 130004707420

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