Ear tubes (tympanostomy tubes) are tiny devices inserted through the eardrum to equalize pressure in the middle ear and allow trapped fluid to drain. This procedure is typically recommended for individuals, often children, who experience chronic middle ear infections or persistent fluid accumulation causing hearing difficulties. Because the tube creates an open pathway to the middle ear, standard ear hygiene methods must be significantly modified. A gentle approach is necessary to safely manage normal ear wax and minor drainage while keeping the middle ear protected.
Routine Daily Care for Ears with Tubes
The safest method for cleaning an ear with a tube focuses entirely on the outer ear and the immediate opening of the ear canal. Use a clean, soft washcloth or a cotton ball that is dry or slightly damp with clean water to wipe the visible outer surface of the ear. The goal is to remove any dirt or wax that has naturally migrated outward without pushing anything inward.
Never insert anything into the ear canal, including cotton swabs, fingers, or hairpins, as this risks pushing the tube out of place or damaging the eardrum. The ear is self-cleaning, and inserting objects can compact earwax against the tube, potentially blocking it. If you observe minor, clear, or slightly bloody drainage, especially in the first few days after placement, gently wipe it away from the opening with a clean tissue or cotton ball.
Do not use over-the-counter preparations like wax removal drops, hydrogen peroxide, or topical pain medications. These substances can pass through the tube into the middle ear. Products toxic to the inner ear, such as hydrogen peroxide, must be avoided as they can cause irritation or long-term damage. Only prescription ear drops specifically approved by a physician should ever be placed inside the ear canal.
Essential Water Precautions and Management
Preventing water from entering the ear canal is a primary concern because the tube bypasses the eardrum’s natural barrier, allowing water and bacteria to reach the middle ear and cause infection. During bathing and showering, use ear protection, particularly when washing hair. Soapy water has a lower surface tension and can pass through the tube more easily than plain water. A cotton ball coated with petroleum jelly and placed over the ear canal opening provides a simple, effective seal against splashing water.
Many physicians recommend using ear protection for all water activities, especially if the head will be submerged. For swimming, over-the-counter silicone putty earplugs or custom-fitted ear molds provide a secure, watertight seal. A swimmer’s headband worn over the ears offers an extra layer of protection by keeping the earplugs in place.
Surface swimming in a clean, chlorinated pool is low-risk, but total head submersion, deep diving, or swimming in unchlorinated water carries a higher risk. Avoid swimming in lakes, rivers, or oceans unless specifically advised by a doctor, as the high concentration of bacteria in these natural bodies of water increases the chance of infection. If water enters the ear, monitor the ear for signs of drainage and contact a healthcare provider if discharge occurs.
Recognizing Complications and Needing Medical Advice
While ear tubes improve ear health, complications can occur, requiring professional attention. The most common sign of infection is otorrhea, which is persistent drainage from the ear canal through the tube. This discharge may be yellow, green, or cloudy white, and it can be thick or have a foul odor. This distinguishes it from the minor, clear fluid that may appear immediately after the procedure.
Contact your healthcare provider if drainage is visible for more than seven days, even while using prescribed antibiotic ear drops. You should also seek medical advice if the tube appears to have fallen out prematurely, which may be visible as a small object in the outer ear canal or on a pillow. Timely consultation ensures that any infection is treated properly with the correct prescription ear drops, which are often more effective than oral antibiotics for this type of infection.
Symptoms Requiring Medical Attention
- Severe or increasing ear pain.
- Fever above 102 degrees Fahrenheit.
- A sudden change in hearing or balance.