Ear tubes, also known as tympanostomy or ventilation tubes, are tiny devices inserted into the eardrum during a minor surgical procedure. Their purpose is to treat chronic middle ear issues, such as recurrent acute infections or persistent fluid buildup behind the eardrum, which is called otitis media with effusion. The tubes function by creating an airway to ventilate the middle ear, equalizing pressure, and allowing fluid to drain. This process helps to improve hearing and prevent long-term complications. These short-term tubes are specifically designed to be temporary, and they will naturally fall out, or extrude, as the eardrum heals. Most tubes will extrude spontaneously within 6 to 18 months of placement.
Immediate Actions
Finding a loose ear tube can be surprising, but the first step is to remain calm, as this is a normal and expected part of the healing process. You should not attempt to push the tube back into the ear or use any instruments to reach inside the ear canal. Inserting anything could cause damage to the sensitive ear canal skin or the eardrum itself.
You should avoid using cotton swabs to retrieve the tube, as this can push it deeper into the ear canal or cause injury. If the tube has fallen completely out of the ear, you can place it in a clean, small container or a sealed plastic bag. Saving the tube allows your healthcare provider to inspect it and confirm the entire device has been removed.
Afterward, you should observe the child for any signs of discomfort or distress. While the tube’s extrusion should not cause pain, you should note any new symptoms like ear pain, fever, or excessive drainage from the ear. Mild discharge, which may be thin, clear, or slightly pink, can occur for a few days following the tube’s exit.
Consulting Your Healthcare Provider
Contacting your child’s ear, nose, and throat (ENT) specialist or pediatrician is the necessary next step after noticing the tube has come out. This communication is essential to schedule a follow-up examination to ensure the eardrum is healing properly. The urgency of the call depends on the symptoms observed.
You should contact your provider immediately if you notice severe ear pain, fever, or excessive, persistent drainage that continues for more than a few days. These symptoms could indicate an acute infection or another issue requiring prompt attention.
When speaking with the office, you should provide specific details, including which ear the tube came out of, the date of its original placement, and when you noticed the extrusion.
The follow-up appointment is important because the provider will use a specialized instrument to examine the eardrum. They need to confirm that the small incision where the tube sat has completely closed. This check ensures that the middle ear is sealed off again, maintaining its sterile environment and preventing fluid from reaccumulating.
What Happens After the Tube Comes Out
The event of the tube falling out, known as extrusion, signifies the natural conclusion of the device’s function as the eardrum pushes it out. In the vast majority of cases, the small hole in the tympanic membrane closes on its own within a few weeks of the tube’s exit. The healing process of the eardrum is highly effective due to its regenerative nature.
The small incision may leave a minor area of thinning or a white patch on the eardrum, called tympanosclerosis. This is a common and usually harmless change that does not affect hearing.
In a small percentage of patients, the tiny hole may not close completely, resulting in a persistent perforation. Your doctor will monitor this and may recommend a minor surgical patch if it does not heal spontaneously.
If the tube comes out much sooner than the expected 6 to 18-month timeframe, it is considered a premature extrusion. This event may increase the risk of the original middle ear fluid buildup or infections returning. If the underlying condition has not fully resolved, the doctor may discuss the possibility of inserting a second set of tubes to ensure the long-term health of the middle ear.