Ear tubes, also known as tympanostomy or pressure equalization (PE) tubes, are tiny, hollow cylinders surgically placed into a child’s eardrum to treat middle ear problems. Their primary purpose is to create an open channel, allowing air to flow into the middle ear space. This ventilation equalizes pressure and prevents the damaging buildup of fluid behind the eardrum.
Conditions That Require Ear Tubes
The decision to place ear tubes is driven by a few specific medical issues affecting the middle ear space. The most frequent indication is recurrent acute otitis media (RAOM), which involves multiple ear infections occurring over a short period. Physicians typically consider tube placement if a child experiences three or more distinct ear infections in six months or four or more infections within one year, especially when antibiotics have not been fully effective.
Another major reason for tube insertion is persistent otitis media with effusion (OME), commonly known as “glue ear.” This condition is characterized by fluid remaining in the middle ear for three months or longer, even without an active infection. This persistent fluid can lead to temporary hearing loss because it prevents the eardrum and tiny middle ear bones from vibrating correctly. Prolonged conductive hearing loss in young children can interfere with speech and language development, making intervention necessary.
Both of these conditions are often linked to a dysfunction of the Eustachian tube. In young children, the Eustachian tube is narrower and positioned more horizontally than in adults. This anatomical difference makes it challenging for the tube to drain fluid or equalize pressure effectively, leading to blockages and fluid accumulation within the middle ear. The tubes function as an artificial, temporary Eustachian tube, promoting proper drainage and aeration until the child’s natural anatomy matures.
How Often Are Ear Tubes Placed
Tympanostomy tube insertion is considered one of the most common surgical procedures performed on children in the United States and globally. This frequency reflects the high incidence of middle ear issues in the pediatric population. Each year, approximately one million children undergo this procedure.
The age group most frequently affected by these conditions is between one and three years old. During this time, children are highly susceptible to respiratory illnesses and associated Eustachian tube dysfunction. Tube placement offers a relatively simple, temporary solution to manage the effects of chronic fluid and recurrent infection. This intervention provides relief and helps prevent developmental delays related to hearing loss.
What to Expect During Surgery and Recovery
The procedure to insert ear tubes is called a myringotomy with tube placement and is generally performed on an outpatient basis. The entire process is brief, typically lasting only about 15 minutes. A pediatric ear, nose, and throat surgeon performs the procedure while the child is under general anesthesia.
During the myringotomy, the surgeon makes a small, precise incision in the eardrum to access the middle ear. Any existing fluid is removed through this incision, and then the tiny tube is placed into the opening. This tube immediately restores ventilation to the middle ear space. Children are usually monitored for a short period in a recovery area and are able to return home the same day.
Post-operative care is straightforward, and the child’s hearing is often immediately improved once the fluid is gone. While tubes are in place, there may be temporary recommendations regarding water exposure, such as using earplugs during swimming or bathing in certain situations, to minimize the risk of infection. Follow-up appointments are scheduled to ensure the tubes are functioning correctly and the middle ear is healthy.
The tubes are designed to be temporary, and the natural healing process of the eardrum pushes the tube out over time. This process, called extrusion, usually occurs between six and eighteen months after placement. Once the tube falls out, the small hole in the eardrum typically closes and heals completely on its own. In a small percentage of cases, the tube may remain longer or the hole may not close, requiring a minor follow-up procedure.