Tympanostomy is the most frequently performed surgery procedure in Germany. It enables middle ear ventilation and discharge of secretion from the middle ear with immediate hearing improvement and avoidance of complications and long-term pathologies of the tympanic membrane and the tympanum. The economical importance is emphasized by the fact that about 300,000 myringotomies are performed yearly. The best type of middle ear drainage and ventilation should be chosen on a case-by-case basis. In this context, the various techniques like conventional myringotomy, laser-myringotomy, short-term and long-term tympanostomy tubes and indications, complications and their treatments are described.