Ear tubes are a common medical intervention for recurring ear issues, particularly in children. These small, hollow cylinders help manage conditions affecting the middle ear. Their placement is a common outpatient surgery.
Understanding Ear Tubes
Ear tubes, also known as tympanostomy, ventilation, or myringotomy tubes, are tiny, hollow cylinders made of plastic or metal. They are surgically inserted into the eardrum to create an airway into the middle ear. This opening allows air to circulate and prevents fluid from accumulating behind the eardrum.
These tubes are recommended for conditions involving inflammation or fluid buildup in the ear. A primary reason for their placement is recurrent acute otitis media, or repeated ear infections caused by bacteria or viruses. Children who experience three or more infections within six months, or four or more within a year, may benefit from ear tubes.
Another condition necessitating ear tubes is persistent fluid buildup in the middle ear, known as otitis media with effusion, or “glue ear.” This can occur after an infection or due to issues with the Eustachian tubes, which are narrower and more horizontal in young children, making them prone to clogging and poor drainage. Fluid accumulation can lead to hearing loss, balance problems, and even speech or learning delays.
By allowing air into the middle ear and facilitating fluid drainage, ear tubes reduce the frequency and severity of ear infections. They can also improve or restore hearing, which supports speech development and may alleviate related behavioral or sleep issues. In cases of chronic middle ear infections that do not respond to antibiotics, tubes can aid in draining the ear and allow for direct application of antibiotic drops.
The Ear Tube Procedure and What to Expect
The placement of ear tubes, a procedure called myringotomy with tube insertion, is a common outpatient surgery. For children, this procedure is performed under general anesthesia to ensure comfort during the brief operation. Adults may receive local anesthesia.
During the procedure, a small incision, around 2 millimeters, is made in the eardrum. Any trapped fluid in the middle ear is then drained or suctioned out. The ear tube is inserted into this incision. The entire process takes about 10 to 15 minutes.
Recovery is quick with minimal discomfort. Patients go home the same day as the surgery. Some mild grogginess or nausea from the anesthesia may occur, and a small amount of clear, yellow, or blood-tinged drainage from the ear is common for a day or two. Pain is mild and can be managed with over-the-counter pain relievers.
Ear tubes remain in place for about 9 to 18 months, or up to two years, and fall out on their own as the eardrum heals. The small hole in the eardrum where the tube was inserted closes naturally. While tubes are in place, surface swimming in clean, chlorinated pools is safe without earplugs, as the small opening of the tubes makes it difficult for water to enter. For activities involving deeper submersion or in lakes, rivers, or hot tubs where bacterial loads are higher, ear protection may be recommended.
Tubes may fall out earlier than expected, sometimes requiring reinsertion if infections recur. Rarely, a tube may remain in place for too long and might need surgical removal after two to three years. In rare instances, a small hole in the eardrum may persist after the tube falls out, which might require a separate surgical repair. While tubes significantly reduce ear infections, they do not eliminate them entirely, though any infections that do occur are often milder.