Ear tubes (tympanostomy or ventilation tubes) are tiny, hollow cylinders surgically placed into the eardrum to manage chronic ear conditions. Their primary purpose is to provide a temporary airway that ventilates the middle ear space and helps equalize pressure. This ventilation allows built-up fluid to drain, preventing the negative pressure and fluid accumulation often seen with recurrent ear infections.
Inserting ear tubes is one of the most common surgeries performed on children, typically taking only 10 to 15 minutes under general anesthesia. Risks associated with the surgery are low, and benefits include an immediate improvement in hearing and a significant reduction in the frequency and severity of ear infections. Understanding the recovery process and ongoing care is important for managing the tubes until they naturally fall out.
Immediate Recovery and Initial Drainage
Following the brief procedure, the first 24 to 48 hours focus on recovery from the general anesthesia, which can cause grogginess, irritability, or nausea. Most patients experience only mild discomfort or pain, which is typically managed effectively with over-the-counter pain relievers like acetaminophen or ibuprofen. A full return to normal activity, including school or daycare, is usually possible the day after the surgery.
Fluid drainage from the ear is common in the first one to two days after tube placement. This initial discharge is residual fluid draining from the middle ear through the tube opening. It may appear clear, slightly yellow, or tinged with blood. If prescribed, antibiotic ear drops are often started immediately to minimize infection risk and manage this initial drainage.
Monitoring the discharge is important, as a small amount indicates the tubes are working to clear the middle ear space. However, drainage that becomes thick, foul-smelling, or persists beyond a few days may indicate an infection requiring medical attention. Any significant or worsening pain not relieved by medication should prompt a call to the healthcare provider.
Ongoing Care and Daily Precautions
Daily care focuses on the proper administration of prescribed medications and taking appropriate water precautions. If antibiotic ear drops were prescribed, they must be used exactly as instructed, often for several days to ensure the surgical site heals cleanly. The drops are effective because they are delivered directly to the middle ear space through the tube opening, treating the area where fluid was previously trapped.
Regarding water exposure, the highest risk for water entering the middle ear is with soapy water due to its lower surface tension, such as during hair washing or bathing. For this reason, many specialists recommend using earplugs or cotton balls coated with petroleum jelly to protect the ears during baths and showers. For swimming, national guidelines suggest that ear protection is often not necessary for surface swimming in clean, chlorinated pools.
Special precautions are advised, however, when swimming in untreated water like lakes or oceans, or when diving deeper than a few feet, as this increases the likelihood of water entering the tube. If an ear infection develops while the tubes are in place, the first sign is often drainage, and a course of antibiotic ear drops is typically the primary treatment.
Routine follow-up appointments monitor the tubes’ function and position. The first check-up is usually scheduled a few weeks post-surgery, followed by appointments every four to six months until the tubes are naturally expelled. These visits ensure the tubes remain open and that the eardrum is healthy.
Long-Term Function and Tube Extrusion
The primary long-term outcome of ear tube placement is the resolution of chronic middle ear fluid and a significant reduction in ear infection frequency. Many patients experience an immediate improvement in hearing once the fluid is drained and the middle ear pressure is equalized. This restoration of hearing is particularly important in children, as it supports speech development that may have been hindered by muffled hearing.
Ear tubes are designed to be temporary, with most standard tubes remaining in place for an average of 6 to 18 months before they are naturally expelled. This process is called extrusion, occurring as the eardrum heals and pushes the tube outward into the ear canal. Extrusion is the expected end to the tube’s lifespan, and the tiny hole where the tube was placed typically closes on its own.
In a small percentage of cases, approximately 1% to 2%, the eardrum may not fully close after the tube extrudes, leaving a small perforation. This residual hole is monitored by the specialist and may require a minor surgical procedure to repair if it does not heal naturally. In rare instances, if a tube remains in place for an extended period, such as two to three years, a surgeon may need to remove it to prevent complications like long-term eardrum scarring.