Ear tubes (tympanostomy or pressure equalization tubes) are tiny hollow cylinders surgically placed into the eardrum. Their primary function is to provide an alternate pathway for air to enter the middle ear, a space normally ventilated by the eustachian tube. This procedure treats chronic fluid buildup behind the eardrum (otitis media with effusion) or recurrent acute ear infections unresponsive to other treatments. By equalizing pressure and allowing fluid to drain, the tubes restore hearing and reduce infection frequency. This procedure is needed when the body’s natural pressure regulation system is ineffective, particularly in young children whose eustachian tubes are still developing.
The Precise Location of Tube Placement
The tube is placed directly within the tympanic membrane, the technical term for the eardrum. This membrane is a thin, cone-shaped layer of tissue that separates the outer ear canal from the middle ear space. The surgeon creates a small opening, typically in the lower front quadrant of the eardrum, to insert the tube. This location is chosen because it is the thinnest part of the membrane and is farthest away from the delicate structures of the inner ear.
The tube acts as a small vent, creating a channel between the outer ear canal and the air-filled middle ear space. This connection allows air to flow freely, immediately equalizing the pressure on both sides of the eardrum. Ventilation is necessary for the eardrum to vibrate correctly and for collected fluid to drain out. The tube’s position essentially bypasses a malfunctioning eustachian tube.
The Steps of the Insertion Procedure
The procedure for inserting ear tubes is a quick, routine surgery, typically performed in an outpatient setting. General anesthesia is often administered, especially to children, to ensure they remain completely still for comfort and safety. The surgeon uses an operating microscope to gain a magnified view of the eardrum through the ear canal.
The first step, known as a myringotomy, involves making a tiny incision in the eardrum, usually two to three millimeters in length. If fluid has accumulated, a small suction device is passed through this opening to gently remove the fluid. Removing the fluid is important as it can be thick and contain bacteria, contributing to hearing loss and infection.
The small, spool-shaped tympanostomy tube is then carefully inserted into the incision. The flanges, or wider ends, of the tube help secure its position within the membrane. This placement immediately ventilates the middle ear space and prevents the rapid re-accumulation of fluid. The entire surgical process for both ears usually takes only about ten to fifteen minutes to complete.
How Long Ear Tubes Remain in Place
The duration an ear tube remains in place depends on the type used, categorized as short-term or long-term. Short-term tubes are most common and are designed to be temporary. These tubes naturally fall out, or extrude, as the eardrum heals and slowly pushes the tube outward into the ear canal over time.
This natural extrusion process typically occurs within six to eighteen months after insertion. Once the tube has fallen out, the small incision in the eardrum usually closes on its own, leaving the eardrum fully intact. Long-term tubes, which may be needed for chronic or recurring issues, are designed to stay in place longer and may require a second, minor procedure for surgical removal.
Follow-up appointments are necessary to monitor the tube’s function and the condition of the tympanic membrane. The tube’s continuous presence helps ensure the middle ear remains ventilated until the patient’s eustachian tube function matures and works correctly. If the underlying issue of poor middle ear ventilation persists, the problem may return after the tube extrudes, sometimes requiring a repeat procedure.