Tympanostomy tubes (TT) are frequently employed as treatment for otitis media (OM) although there is little-clinical or experimental evidence of their efficacy. Potential detriments of TT include cost, risk of inhalation anesthesia, intraoperative complications, and tympanic membrane (TM) damage. Potential benefits include elimination of the conductive hearing loss (CHL), reduction in the occurrence of acute purulent OM, and avoidance of sequelae. The cost/benefit ratio of TT has never been accurately determined and morbid complications of inhalation anesthesia and the surgical procedure appear to be rate. There is evidence that TT significantly reduce the CHL of OM as well as reduce the incidence of recurrent acute purulent OM and help avoid sequelae. It is therefore determined that the risk of TT insertion for middle ear effusion (occasional TM changes) can be justified, in properly selected patients, by the benefits (immediate improvement in hearing and reduction in the incidence of recurrent acute purulent OM).