Medial migration of a tympanostomy tube after 30 years: a rare case report

Medial migration of tympanostomy tubes is a rare complication, particularly when detected decades after insertion. We report the case of a 40-year-old female with a history of bilateral tube insertion at the age of five, who presented with intermittent nasal congestion and mild allergic rhinitis. Otoscopic examination revealed an intact tympanic membrane with a bluish-green mass in the middle ear on the right side. Audiologic assessment showed normal hearing and middle ear function. The patient was asymptomatic from an otologic standpoint and opted for conservative management following counselling. This case represents the longest reported duration of medial tube migration, underscoring the potential for long-term retention without complications and the importance of individualized management in asymptomatic adults.