{"id":63886,"date":"2026-08-13T13:34:40","date_gmt":"2026-08-13T06:34:40","guid":{"rendered":"https:\/\/www2.si.mahidol.ac.th\/en\/?p=63886"},"modified":"2026-08-13T13:38:50","modified_gmt":"2026-08-13T06:38:50","slug":"tympanostomy-tube-insertion-in-children-an-innovation-for-hearing-and-quality-of-life","status":"publish","type":"post","link":"https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/tympanostomy-tube-insertion-in-children-an-innovation-for-hearing-and-quality-of-life\/","title":{"rendered":"Tympanostomy Tube Insertion in Children: An Innovation for Hearing and Quality of Life"},"content":{"rendered":"<div id='av_section_1'  class='avia-section av-c6wjyfi-39442840ffa9096b85fa617c36cf25e3 main_color avia-section-small avia-no-border-styling  avia-builder-el-0  el_before_av_section  avia-builder-el-first  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  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itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><h2><strong>Tympanostomy Tube Insertion in Children:<\/strong><\/h2>\n<h2><strong>An Innovation for Hearing and Quality of Life<\/strong><\/h2>\n<\/div><\/section><\/div><div  class='flex_column av-7vva13i-c75faa080bd02e46f2627099b92a1551 av_one_fifth  avia-builder-el-11  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  '     ><\/div><div  class='flex_column av-7rbhoku-04b297799851c44f5398a3f65d1aba6c av_one_fifth  avia-builder-el-12  el_after_av_one_fifth  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-72vgvbi-229532a7bb9341762e0ac4428a4ba9af av_three_fifth  avia-builder-el-13  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><p><section  class='av_textblock_section av-msr4zi1a-fb2eb52719e5ea26a2ee2899b757c922 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-63887 size-medium\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-191x300.jpg\" alt=\"\" width=\"191\" height=\"300\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-191x300.jpg 191w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa.jpg 308w\" sizes=\"auto, (max-width: 191px) 100vw, 191px\" \/><\/p>\n<p>By <strong>Assistant Professor Vannipa Vathanophas, M.D.<\/strong><br \/>\nDepartment of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University<\/p>\n<\/div><\/section><br \/>\n<section  class='av_textblock_section av-msr50ub5-83f92dd760aec9a57299446005d9ada4 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p data-path-to-node=\"6\">Chronic otitis media (COM) and otitis media with effusion (OME) are prevalent clinical problems in children, particularly those with cleft palate anomalies. These conditions significantly impair auditory acuity and language development. If left untreated, they can culminate in long-term learning deficits and a diminished quality of life.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-63888 size-full\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-1.jpg\" alt=\"\" width=\"1039\" height=\"702\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-1.jpg 1039w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-1-300x203.jpg 300w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-1-1030x696.jpg 1030w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-1-768x519.jpg 768w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/08\/Vannipa-1-705x476.jpg 705w\" sizes=\"auto, (max-width: 1039px) 100vw, 1039px\" \/><\/p>\n<h3 data-path-to-node=\"7\"><b data-path-to-node=\"7\" data-index-in-node=\"0\">Treatment via Tympanostomy Tube Insertion<\/b><\/h3>\n<p data-path-to-node=\"8\">Tympanostomy tube insertion is a universally accepted therapeutic procedure. The physician performs a myringotomy (an incision of the tympanic membrane) and inserts a micro-tube to facilitate fluid drainage and equalize middle ear pressure. Although it may appear to be a straightforward procedure, it is fundamentally an otologic microsurgery performed within a highly confined and delicate surgical field. It demands surgical proficiency, precision, and standardized instrumentation to achieve maximal safety and optimal efficacy for pediatric patients.<\/p>\n<h3 data-path-to-node=\"9\"><b data-path-to-node=\"9\" data-index-in-node=\"0\">Tympanostomy Tube Innovation: From Manufacturing to Elevating the Quality of Life for Thai Children<\/b><\/h3>\n<p data-path-to-node=\"10\"><b data-path-to-node=\"10\" data-index-in-node=\"0\">The Challenges in Manufacturing Pressure Equalization (PE) Tubes<\/b> Despite the critical role of tympanostomy tubes, the manufacturing of PE tubes is highly complex and capital-intensive due to:<\/p>\n<ul data-path-to-node=\"11\">\n<li>\n<p data-path-to-node=\"11,0,0\"><b data-path-to-node=\"11,0,0\" data-index-in-node=\"0\">Microscopic Dimensions:<\/b> With a diameter of merely a few millimeters, fabrication requires ultra-high precision molding technology.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"11,1,0\"><b data-path-to-node=\"11,1,0\" data-index-in-node=\"0\">Complex Manufacturing Processes:<\/b> Production entails precision molding, meticulous surface smoothness inspections, and rigorous durability testing.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"11,2,0\"><b data-path-to-node=\"11,2,0\" data-index-in-node=\"0\">High Costs Abroad:<\/b> Because they are highly specialized medical devices that are difficult to manufacture and require premium biomaterials, the market price is substantially higher than what many parents anticipate.<\/p>\n<\/li>\n<\/ul>\n<p data-path-to-node=\"12\"><b data-path-to-node=\"12\" data-index-in-node=\"0\">The PE Tube Manufacturing Process at the Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital<\/b> Local production was initiated over 30 years ago when <em>Assistant Professor Prasit Srisomboon, MD, FICS, FACS<\/em>, began utilizing medical-grade polyethylene to fabricate the Department\u2019s proprietary PE tubes. This highly precise manufacturing process encompasses:<\/p>\n<ul data-path-to-node=\"13\">\n<li>\n<p data-path-to-node=\"13,0,0\"><b data-path-to-node=\"13,0,0\" data-index-in-node=\"0\">Precision Molding:<\/b> To achieve the optimal dimensions and morphology.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"13,1,0\"><b data-path-to-node=\"13,1,0\" data-index-in-node=\"0\">Surface Inspection:<\/b> Ensuring a smooth surface to minimize the accumulation of debris.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"13,2,0\"><b data-path-to-node=\"13,2,0\" data-index-in-node=\"0\">Durability Testing:<\/b> Guaranteeing that the tube remains functional for its intended indwelling duration.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"13,3,0\"><b data-path-to-node=\"13,3,0\" data-index-in-node=\"0\">International Standardization:<\/b> The efficacy of these tubes has been validated and published in international peer-reviewed journals.<\/p>\n<\/li>\n<\/ul>\n<h3 data-path-to-node=\"14\"><b data-path-to-node=\"14\" data-index-in-node=\"0\">Techniques for Fabricating PE Tubes in Resource-Limited Settings<\/b><\/h3>\n<p data-path-to-node=\"15\">In healthcare facilities constrained by limited resources, functional PE tubes can be manually fabricated using fundamental equipment:<\/p>\n<ul data-path-to-node=\"16\">\n<li>\n<p data-path-to-node=\"16,0,0\">An alcohol lamp<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"16,1,0\">A glass slab for flanging the tube<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"16,2,0\">A section of polyethylene tubing, 6\u20137 mm in length<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"16,3,0\">A 20-gauge microsuction tube<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"16,4,0\">A magnifying loupe for inspection<\/p>\n<\/li>\n<\/ul>\n<p data-path-to-node=\"17\"><b data-path-to-node=\"17\" data-index-in-node=\"0\">Fabrication Methodology:<\/b><\/p>\n<ol start=\"1\" data-path-to-node=\"18\">\n<li>\n<p data-path-to-node=\"18,0,0\">Mount the polyethylene tube onto the tip of the microsuction.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"18,1,0\">Apply heat from the flame to soften the material while ensuring a central lumen forms and remains open.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"18,2,0\">Press the heated tip against the glass slab to flatten it into a circular shape (flange).<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"18,3,0\">Repeat the identical process on the contralateral end.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"18,4,0\">Inspect the dimensional accuracy using a magnifying loupe.<\/p>\n<\/li>\n<\/ol>\n<p data-path-to-node=\"19\"><b data-path-to-node=\"19\" data-index-in-node=\"0\">Outcome:<\/b> The resulting tube exhibits perfect symmetry with bilateral circular flanges, featuring standardized dimensions suitable for practical clinical application.<\/p>\n<h3 data-path-to-node=\"20\"><b data-path-to-node=\"20\" data-index-in-node=\"0\">Domestic Pricing in Thailand<\/b><\/h3>\n<p data-path-to-node=\"21\">While imported PE tubes command a premium price, the Chaladkid Center at the Faculty of Medicine Siriraj Hospital distributes these proprietary tubes at a highly accessible price point of 300 THB per 3 units. This cost is significantly lower than international equivalents, yet it maintains the rigorous clinical quality that has been published and certified by international standards.<\/p>\n<h3 data-path-to-node=\"22\"><b data-path-to-node=\"22\" data-index-in-node=\"0\">Conclusion<\/b><\/h3>\n<p data-path-to-node=\"23\">The innovation of Tympanostomy Tube Insertion and the local manufacturing of internationally standardized PE tubes exemplify a true medical advancement that elevates the quality of life for Thai children and their families. Despite the inherent complexities of manufacturing, the Faculty of Medicine Siriraj Hospital\u2019s ability to distribute these devices at an accessible price ensures that a large number of children receive high-quality and safe treatment.<\/p>\n<\/div><\/section><\/p><\/div><div  class='flex_column av-6obrzm6-ea3f320b4a7762c79df03d7aa3a3c3a9 av_one_fifth  avia-builder-el-16  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-6dkynvy-ae63336376de710c36888afb1f566784 av_one_fifth  avia-builder-el-17  el_after_av_one_fifth  el_before_av_one_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-5v8oy0e-6d4fa1f738f4ee85246154baaa007674 av_one_fifth  avia-builder-el-18  el_after_av_one_fifth  avia-builder-el-last  flex_column_div  column-top-margin'     ><\/div><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_4'  class='avia-section 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itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><h1>Related Highlights<\/h1>\n<\/div><\/section><\/div><div  class='flex_column av-3zzfb1q-6e49e2719ecdc52794ef72ca6cdad96e av_one_fifth  avia-builder-el-22  el_after_av_one_full  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-3cwtgzy-43c1b000dc32a21eed0de09bcced78de av_three_fifth  avia-builder-el-23  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><div  id=\"avia-magazine-1\"  class='av-magazine av-2x35xe6-c268ab5de754b37c5ec593ed6dcdec3c  avia-builder-el-24  avia-builder-el-no-sibling   avia-builder-el-24  avia-builder-el-no-sibling ' ><div class='av-magazine-group sort_all'><article class='av-magazine-entry av-magazine-entry-id-62742 av-magazine-format-standard av-magazine-type-post av-magazine-entry-1 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/siriraj-faculty-abroad-at-the-36th-american-glaucoma-society-aunnual-meeting-in-usa\/' title='Link to: Siriraj Faculty Abroad at the 36th American Glaucoma Society Aunnual Meeting  in USA' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/03\/Feature-80x80.jpg\" class=\"wp-image-62743 avia-img-lazy-loading-not-62743 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/03\/Feature-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/03\/Feature-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/03\/Feature-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Siriraj Faculty Abroad at the 36th American Glaucoma Society Aunnual Meeting  in USA\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-03-05T16:27:46+07:00\" >March 5, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/news-events\/siriraj-faculty-abroad-at-the-36th-american-glaucoma-society-aunnual-meeting-in-usa\/' title='Link to: Siriraj Faculty Abroad at the 36th American Glaucoma Society Aunnual Meeting  in USA'>Siriraj Faculty Abroad at the 36th American Glaucoma Society Aunnual Meeting  in USA<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-62460 av-magazine-format-standard av-magazine-type-post av-magazine-entry-2 av-magazine-entry-small '  itemscope=\"itemscope\" 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