Abstract: A tympanostomy tube delivery device comprises a shaft assembly and a handpiece. All or a portion of the shaft assembly is selectively coupleable and removable from the handpiece. The handpiece includes a housing defining an opening that can receive a portion of the shaft assembly. The shaft assembly comprises a cannula, a piercer/dilator tube, a shield tube, and a pusher tube operable to translate relative to the cannula. The pressure equalization tube is positioned within the shield tube of the shaft assembly. The piercer/dilator tube and the shield tube are operable to pierce the tympanic membrane and dilate an opening formed therein. The pusher tube is operable to drive the pressure equalization tube out of the shield tube of the shaft assembly and into the opening formed in the tympanic membrane. Upon completion of the procedure, all or a portion of the shaft assembly may then be removed and replaced.