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Ear tube insertion

Definition

Ear tube insertion is a procedure to drain fluid that has built up behind a child’s eardrums. The purpose of the procedure is to restore the normal functioning of the ear.

Alternative Names

Myringotomy; Tympanostomy; Ear tubes surgery

Description

While the child is under general anesthesia, a small surgical cut is made in the eardrum. The fluid is suctioned out. A small tube is inserted through the eardrum. The tube allows air to flow in, and fluid to continuously flow out, of the middle ear.

The surgical cut heals on its own, without the need for stitches. The hole closes and the ear tubes usually fall out naturally, after an average of 14 months or so.

Indications

The most common reason for ear tube insertion is when the eustachian tube functions poorly, allowing fluid to build up behind a child's eardrum. When this happens for 4 months or longer, and there is also moderate or severe hearing loss, an ear tube is inserted to try to alleviate these problems. This type of hearing loss usually does not affect speech and language development.

Another common reason for inserting an ear tube is infection that doesn't go away with the usual medical treatment.

Some children may be candidates for ear tube surgery regardless of how long the fluid has been present or their hearing ability.

Ear tube insertion is sometimes used for:

  • Acute ear infections
  • Barotrauma from flying or deep sea diving
  • Patients undergoing hyperbaric oxygen therapy
  • Those who have had a complication resulting from a severe ear infection, such as mastoiditis, brain infection, meningitis, or facial nerve paralysis

Risks

The risks for any anesthesia are:

  • Problems breathing
  • Reactions to medications

The risks for any surgery are:

  • Bleeding
  • Infection

Additional risks of this surgery include scarring of the eardrum and drainage from the ear. These complications are usually temporary or do not cause problems in children. Your doctor can explain these complications in more detail. There is a very small risk of a hole remaining in the eardrum after the tube comes out.

Expectations after surgery

After this procedure, most parents report fewer ear infections, faster recovery from infections, and less worrying about whether their children have ear infections.

If ear infections return after the first tubes fall out, the procedure can be repeated with another set of ear tubes.

Convalescence

Patients usually leave the hospital the same day. Check with your ear specialist about bathing or swimming with ear tubes inserted.

References

American Academy of Family Physicians; American Academy of Otolaryngology - Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics. 2004; 113(5):1412-29.

Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, Rockette HE, Pitcairn DL, et al. Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. N Engl J Med. 2007; 356(3):248-61.

Review Date:7/15/2008
Reviewed By:Alan Lipkin, MD, Otolargyngologist, private practice, Denver, CO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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