A tympanostomy tube for insertion into and residence in a tympanic membrane of a mammal, is disclosed. The tympanostomy tube includes a body including a first end portion, a second end portion, a central portion dispensed between the first and second end portions. An axially extending passageway has a first open end disposed adjacent the first end portion, and a second open end disposed adjacent the second end portion, and an axis extending between the first open end and second open end. The first end portion includes a relatively enlarged diameter, generally radially extending flange. The central portion includes a reduced diameter portion sized for extending through and residing in tissue of the tympanic membrane. The second end portion includes a relatively enlarged diameter second flange disposed adjacent the second end portion. The second flange includes a perimetral edge having an incising portion sufficiently sharpened to cut as a knife through the tympanic membrane during insertion of the tympanostomy tube in the tympanic membrane.