An ear tube, also known as a tympanostomy tube or grommet, is a tiny cylinder surgically placed in the eardrum to create an airway to the middle ear space. This procedure allows air to flow into the middle ear, equalizing pressure and preventing the buildup of fluid behind the eardrum. When the tube becomes plugged, often with mucus or thick fluid, it stops functioning, which can lead to discomfort, drainage, and hearing issues. The goal of clearing the tube is to restore its ventilation and drainage capabilities without causing damage.
Understanding Blockages and Tube Function
The core function of the ear tube is to bypass a non-functioning Eustachian tube, which normally manages middle ear pressure and drains fluid into the back of the throat. When the tube is working correctly, it allows the middle ear fluid to drain out into the ear canal. The most common material blocking the tube is thick, dried inflammatory fluid, or mucus, from the middle ear space, especially following an upper respiratory infection.
The blockage can also be caused by earwax migrating into the tube from the outer ear canal. Once the tube is clogged, it no longer allows air to ventilate the middle ear, which can cause fluid to accumulate again behind the eardrum. This accumulation of fluid can lead to a recurrent ear infection and the return of muffled hearing, signaling that the tube has become dysfunctional.
Safe Home Methods for Clearing Mucus
The safest and most common home method for addressing a plugged ear tube involves the use of specific ear drops, which must be approved or prescribed by a healthcare provider. The drops work by dissolving or softening the thick, dried mucus or wax that is obstructing the narrow lumen of the tube. Studies suggest that solutions like 5% sodium bicarbonate (baking soda) or 0.33% acetic acid (vinegar) are effective at clearing thick middle ear fluid. Topical antibiotics, sometimes combined with a steroid, are often prescribed when the blockage is accompanied by signs of infection and drainage.
Proper administration is crucial to ensure the drops reach and pass through the tube effectively. The bottle should first be warmed slightly by holding it in the hand for a few minutes, as cold drops can cause temporary dizziness. The patient should lie on their side with the affected ear facing upward, and the earlobe should be gently pulled to straighten the ear canal. After instilling the prescribed number of drops, a gentle massage on the tragus can help push the liquid deeper into the canal and through the tube. Remain in this position for several minutes to allow the medication time to soak into the blockage.
Parents and caregivers must avoid attempting to clean the tube by inserting any object, such as cotton swabs, into the ear canal. This action can push the blockage material further into the middle ear, cause trauma to the ear canal, or damage the delicate eardrum. A warm compress applied to the outer ear may help promote drainage by thinning the mucus, but this should be done gently.
Signs That Require Professional Medical Attention
Home treatment with prescribed or recommended drops may not always be sufficient to clear a blocked tube, and certain symptoms indicate the need for prompt medical evaluation. A persistent fever, especially above 101.3°F, suggests a possible bacterial infection that may require systemic treatment. Continuous, thick, or foul-smelling drainage that does not resolve after a few days of using medicated drops also warrants a doctor’s visit, as this can signal a more entrenched infection.
Unrelenting ear pain or a return of muffled hearing that fails to improve after home attempts indicate the tube is still dysfunctional and fluid is accumulating again. A medical professional, typically an Ear, Nose, and Throat (ENT) specialist, can visually confirm the blockage and determine the next steps. They can perform a procedure called microscopic suctioning to physically remove the mucus or debris under direct visualization. If the tube cannot be cleared or the infection is severe, the doctor may prescribe stronger topical antibiotic drops or discuss replacing the tube.