We place tubes because in the vast majority of the time, the hole we make in the eardrum will heal closed within a few weeks. The tube is to prevent the hole from closing. There is also no such thing as a “permanent” tube. In essence, the bigger the tube or bigger the inner flanges, the longer they are supposed to stay in. 3-6 months: Fleurstein Split, Small grommets 1-2 years: Collar button, Sheehy tubes 5-10 years: T-tubes The T-tubes are what are generally considered “permanent”, though they do tend to come out over time (a long time). Why not place such tubes more often? It’s because such tubes tend to create eardrum perforations that do not heal up on their own. The bigger the tube, the greater the risk of a “permanent” eardrum perforation that would require surgical correction if the perforation itself is causing problems (recurrent drainage or significant conductive hearing loss). A hole in and of itself that is causing no functional problems does not need any correction.