Abstract: A ventilation tube is disclosed which is adapted to be implanted in the tympanic membrane to ventilate and drain the middle ear. The tube comprises an elongate tubular body, a flange mounted at one end of the body, and the flange includes an incision entry guide portion extending forwardly in a generally axial direction from the remaining portion of the flange, with the guide portion being adapted to initially guide the flange through an incision in the membrane with a minimum of trauma. Also, the ventilation tube includes a notch in the end of the tubular body opposite the flange and which is adapted for cooperation with a mating key on the insertion tool, to facilitate alignment of the guide portion of the flange with the incision during the insertion procedure by precluding relative rotation and tilting between the ventilation tube and insertion tool.