Long-term ventilating tube with tympanosclerosis. (Otoscopic Clinic).

The otoscopic view is that of a left ear with a green Silastic ventilation tube in a myringotomy. The green tube demonstrates one problem that can occur with a long tube. The end of the tube is touching the anterior canal wall, which can cause irritation, discomfort, and sometimes obstruction. It is sometimes necessary to cut the end of the tube in order to prevent it from touching the ear canal. In the photograph, small patches of tympanosclerosis of a cosmetic type can be seen anterior to the malleus and in the posterior half of the tympanic membrane. A crust has formed around the tube near the pars tensa; this is not uncommon when a tube has been in place for a long period of time. The use of a long-term ventilating myringotomy tube is often necessary in patients who have persistent serous otitis media in association with a cleft palate.

From the Pulec Ear Clinic, Los Angeles (Dr. Pulec), and Gap, France (Dr. Deguine).