Tympanostomy tubes, commonly known as ear tubes, are small, hollow cylinders placed into the eardrum to ventilate the middle ear and prevent fluid buildup. This procedure treats chronic ear infections or persistent fluid accumulation that causes hearing loss. The tube creates a passageway, allowing fluid that collects in the middle ear space to drain into the ear canal instead of remaining trapped. Drainage is a common and expected occurrence, especially immediately following the procedure or during a subsequent ear infection.
Expected Appearance of Normal Drainage
Drainage in the immediate days following tube placement surgery is a normal response to the procedure itself. Within the first 24 to 48 hours, it is common to observe a small amount of discharge that may be slightly bloody, pink-tinged, or mixed with clear mucus. This is due to the minor incision made in the eardrum and is typically self-limiting, clearing up quickly within a few days.
Beyond the initial post-operative phase, the tube may still drain fluid. This ongoing, non-infected discharge, known as serous drainage, is typically thin, clear, or slightly straw-colored. This fluid represents the middle ear clearing out the remaining trapped fluid that led to the tube placement. The presence of this drainage confirms the tube is patent, or open, and is ventilating the middle ear space.
Recognizing Signs of Infection and Abnormal Discharge
When ear tube drainage changes its appearance, it is often a sign of a middle ear infection. The most recognizable characteristic of an infected discharge is a change in consistency and color. Infected fluid is frequently thick, opaque, and may appear bright yellow, green, or white, indicating the presence of pus.
This abnormal discharge can also be heavy and continuous, a distinct difference from minor, occasional drainage. A strong indicator of a bacterial infection is a foul or unpleasant odor accompanying the fluid. Although the tube allows infected fluid to drain and relieve pressure, reducing typical ear infection pain, the infection still requires attention. If the discharge is heavy or persists for longer than seven days, even with initial treatment, it signals that the infection is not resolving.
Home Management and Care During Drainage
When drainage is present, whether normal or infected, proper home management is necessary to keep the outer ear clean and prevent irritation. The exterior of the ear and surrounding skin should be gently wiped clean using a soft cloth or cotton ball dampened with warm water. Avoid inserting anything into the ear canal, including cotton swabs, as this can push debris inward or damage the ear structure.
If the discharge is infected and antibiotic ear drops have been prescribed, the application technique is crucial for the medication to reach the middle ear through the tube. The drops should be warmed slightly by holding the bottle in your hand, as cold liquid can cause temporary dizziness. After instilling the correct number of drops, gently press the tragus—the small flap of cartilage in front of the ear canal—a few times. This pumping action helps the medication pass through the tube into the middle ear space to treat the infection directly.
Water precautions are important, especially when drainage is active. During this period, the ear canal should be kept dry, often achieved by placing a cotton ball coated with petroleum jelly over the ear opening during baths. For swimming, earplugs are recommended, especially in non-chlorinated or dirty water, to prevent bacteria from entering the middle ear through the tube.
When to Contact Your Doctor Immediately
While most ear tube drainage can be managed at home or treated with prescription drops, certain signs require an immediate call to your healthcare provider. Persistent high fever accompanying the drainage, especially if it exceeds 102°F a few days after surgery, should be reported. Similarly, if the discharge is accompanied by severe, unmanageable ear pain or a sudden change in behavior, such as lethargy or extreme irritability, contact your doctor.
The sudden appearance of heavy, bright red blood, rather than the minor pink-tinged fluid expected post-surgery, is also a cause for immediate concern. If you notice the ear tube has fallen out (extruded) while the ear is actively draining, or if clear, watery fluid is noticed following a head injury, contact your doctor right away. These acute symptoms require rapid assessment.