Ear tubes – tympanostomy tubes – are a treatment solution for repeated acute otitis media, an infection of the middle ear.
Who needs ear tubes?
Ear infections are a common occurrence for young children. Most ear infections respond quickly to antibiotics and some even improve on their own without treatment. But the middle ear infections occur repeatedly or are accompanied by fluid accumulation (effusion) that causes diminished hearing ear tubes may be beneficial.
Ear tube placement is the most common surgery in children, with the average age for surgery between 1- to 3-years-of-age. However, ear tubes may be placed as early as 6 months of age and as old as teens or adults. Basic guidelines for ear tube placement include:
- Three or more infections over a six month period
- Long term fluid accumulation that affects hearing
- Other less common conditions that can benefit from ear tube placement such as cleft palate, defects in the anatomy of the eustachian tube or eardrum and Down’s Syndrome
The purpose of the eustachian tube, which runs from the nasopharynx to the middle ear, is to provide ventilation to the middle ear, to act as a drainage pathway for ear fluids to prevent accumulation, and to regulate pressure in the middle ear.Ear tubes can also improve balance, speech and hearing problems.
Children are more prone to ear infection because of their eustachian tube anatomy which tends to be shorter, narrower and more horizontal than that of an adult. Poor ventilation and drainage promotes fluid accumulation and leads to middle ear infection.
What are ear tubes?
Ear tubes are tiny hollow tubes made of various materials. There are two types of tubes: short-term and long-term. Short-term tubes are smaller in size and designed to remain in place from six to eighteen months and eventually fall out on their own.Long-term tubes are bigger and have design adaptations that help keep them in place. Some long-term tubes still fall out without intervention, but others require removal by an otolaryngologist.
Ear tube insertion
Ear tubes are placed through a procedure called a myringotomy. Insertion is quick – less than 15 minutes – and relatively safe. It is typically done in an outpatient setting under general anesthesia.
During the procedure a small incision is made in the eardrum and any fluid in the middle ear is gently suctioned away. The tube is then placed in the middle ear.
After ear tube insertion
Antibiotic ear drops are prescribed for a few days after the surgery and normal activity may be resumed after 24 hours.
Swimming and bathing are allowed, but earplugs may be recommended if swimming in lakes, hot tubs, streams or other areas that have high risk of bacteria.
Possible complications of ear tube surgery
The risk of complications associated with ear tube placement is low, but rarely the following can occur:
- Scarring of the ear drum
- Failure of the incision site in the eardrum to close
- Blocked tubes due to mucus or blood drainage
- Ear tubes fall out too soon or remain in place too long