To remove or not to remove: Review of cases of medial migration of tympanostomy tubes

Objective: Few cases of medial migration of tympanostomy tubes have been reported and its optimal management has not been well delineated especially in asymptomatic patients. The aim of this review is to present all cases of medialized tympanostomy tubes reported in the literature in order to provide the most beneficial management option. Methods: Eligible articles were identified through a comprehensive search in Cochrane, Embase and Medline electronic databases. Two reviewers independently screened the data sources, using predefined inclusion criteria to generate a list of eligible articles. Data extracted included patient demographics, diagnosis, type of tube, timing of migration, presenting symptoms, examination outcomes, treatment and follow up. Results: 10 articles were chosen for data extraction from which 29 patients presenting with medial migration of tympanostomy tube were identified. Conclusion: The low complications associated with removing a medialized tube and the risk of leaving foreign objects in the middle ear cleft make myringotomy for removal of the tube a practical and safe management option for medialized tubes even in asymptomatic patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved.