OCCASIONALLY it is advisable to place a ventilation tube into an ear in which the tympanic membrane is atrophic, relaxed, and flaccid. The atrophic tympanic membrane does not have sufficient tissue in the middle fibrous layer to retain a prosthesis, be it tube or button. In these instances the prosthesis placed through the tympanic membrane ordinarily is extruded in a very short time.
A procedure by which a tunnel is created and in which the skin of the wall of the external auditory canal and the fibrous tissue of the fibrocartilaginous tympanic ring are used to provide sufficient tissue to hold a ventilation tube in place has proved very helpful in such cases. The technique as demonstrated in Fig 1, 2, and 3 is simple and does not require unusual equipment. The entire dissection can be done with a myringotomy knife. An incision approximately 5 mm long is made about
Kinsey M. Simonton. Ventilation TympanotomyTunnel Technique. Arch Otolaryngol. 1968;87(6):644. doi:10.1001/archotol.1968.00760060646018