Tympanostomy tubes, their use, abuse, and cost-benefit ratio.

Tympanostomy tubes are employed when middle ear ventilation is indicated, particularly when other forms of treatment have failed. Few other uses have broad acceptance. Any other insertion of a ventilating tube implies abuse, either through error in diagnosis or deliberate misapplication. Hard statistical data relating to abuse are impossible to obtain, but ample illustrations can be cited. The cost-benefit ratio is difficult to assess. Cost of a myringotomy and tube versus the cost of a tympanomastoidectomy was determined in four geographic areas. These figures, however, do not reveal how many ears were spared and how much hearing was conserved by tympanostomy tubes. Informed, diligently aggressive use of tympanostomy tubes offers greater potential to avoid serious middle ear disorders and complications than any other single modality.