Ear tubes, also known as tympanostomy tubes or pressure equalization (PE) tubes, are small, hollow cylinders surgically placed into the eardrum. This procedure is commonly performed to address recurrent middle ear infections (acute otitis media) or persistent fluid buildup behind the eardrum (otitis media with effusion). These conditions can lead to issues such as hearing loss, speech delays, and balance problems, particularly in children. The tubes create an airway that helps ventilate the middle ear and allows trapped fluid to drain, preventing further complications.
Expected Bleeding After Ear Tube Placement
A small amount of bleeding is common and expected immediately following ear tube insertion. This happens because a tiny incision, called a myringotomy, is made in the eardrum to place the tube. The ear canal contains small blood vessels that can be affected during this process.
Normal bleeding appears as a few drops of bright red blood, blood-tinged discharge, or a small amount on a cotton ball. It is temporary and subsides quickly, often within 24 to 48 hours after the procedure. Drainage may also appear thin, watery, pink, clear, or yellow. This initial blood-tinged drainage is a normal part of the healing process as the ear adjusts to the tube and drains remaining fluid.
When Bleeding is a Concern
While some bleeding is normal, certain signs indicate it is not typical and warrants medical attention. Heavy bleeding that soaks through dressings quickly or continuous bleeding beyond the initial 48 hours after surgery are concerning. Bright red bleeding that persists for an extended period, rather than gradually diminishing, should also be evaluated.
Bleeding with other symptoms like severe or worsening pain not relieved by over-the-counter medication, a fever above 101-102°F, dizziness, or a sudden change in hearing requires immediate contact with a healthcare professional. Bloody drainage that appears several months after surgery might signal an infection, an inflammatory reaction to the tube, or that the tube is starting to come out. If the drainage becomes thick, green, or has a strong odor, it could indicate an infection. In such cases, contact the surgeon, pediatrician, or seek emergency medical services for guidance.
Managing Recovery and Other Discharges
Post-operative care for ear tubes focuses on overall healing and preventing complications, beyond just monitoring bleeding. Pain after ear tube placement is minimal and can be managed with acetaminophen or ibuprofen. Children resume normal activities, including school or daycare, the day after surgery.
Avoiding water in the ears is advised, particularly for swimming in lakes or oceans, where custom earplugs are recommended. For bathing or showering, some doctors suggest using cotton balls with Vaseline to protect the ears from soapy water. Other types of discharge can occur later, such as clear, yellowish, or pus-like drainage, which may indicate an infection. Infections with tubes often respond well to antibiotic ear drops. Follow-up appointments, scheduled a few weeks after surgery and then every four to six months, are important to monitor the tubes and ensure proper healing.