Ear Tube Placement Surgery in Adults: Everything You Need to Know

Ear tube placement surgery is a procedure to implant synthetic ear tubes into the ear drum or tympanic membrane. In adults, it may be done for people who are having trouble hearing because of a buildup of fluid in the middle ear or have experienced barotrauma due to extreme air pressure changes.

The tubes, also called pressure equalization tubes, ventilation tubes, ear grommets, or tympanostomy tubes, are used to allow proper ventilation and drainage of the middle ear.

What Is Ear Tube Placement Surgery?

The surgical placement of ear tubes is a relatively simple procedure that involves making a small hole in the tympanic membrane (eardrum) with a scalpel or laser—a procedure called a myringotomy—and then inserting a synthetic tube.

In adults, the procedure can be done in a healthcare provider's office with local anesthesia. It takes only about 15 minutes.

Contraindications

A myringotomy with ear tube insertion may not be right for everyone. The procedure is contraindicated for patients with any sign of middle ear mass or vascular anomaly, including a glomus tumor, high-riding jugular bulb, or displaced internal carotid artery.

Another determining factor is whether you have had previous radiotherapy of the head or neck. That may disqualify you from this procedure. 

Potential Risks

While ear tube placement surgery is a safe and common procedure, some complications may arise, including:

• Scarring of the eardrum
• Tubes falling out or being unable to come out
• The hole may not close after tube removal and may require a second procedure to repair the eardrum
• Continuous ear draining, a condition known as otorrhea

Ear tubes are typically temporary and the procedure may need to be repeated. This may cause the eardrum to scar or harden after multiple tube placements. In addition, the procedure may not correct the problem.

Purpose of Ear Tube Placement

In adults, artificial ear tubes are used to ventilate and drain the middle ear and treat certain conditions after first-line treatment has failed. Conditions that may require a myringotomy with ear tube insertion include:

• Fluid in the ear (glue ear, otitis media with effusion, or serous otitis media) that does not go away on its own or causes problems with hearing, balance, or speech
• Ear infections that are frequent or do not resolve with other treatments
• Retracted eardrums
• Auditory tube dysfunction (a condition often caused by chronic allergies in adults)
• Barotrauma due to air pressure changes, such as during air travel or scuba diving

It is possible to have more than one of these conditions at the same time. For example, auditory tube dysfunction can often lead to ear infections, persistent fluid in the ears, or retracted eardrums. Abnormalities in an adult's ear anatomy, often present from birth, can contribute to the development of these conditions as well. Otolaryngologists will usually check the back of the nose (nasopharynx) in adult patients who require ear tubes, as this can be an early sign of nasopharyngeal cancer.

Several types of synthetic ear tubes exist and they vary in the materials they are made of as well as the design of the tubes. The type of tube used will depend on your condition and how your ear canal and eardrum are shaped.

Short-term tubes, commonly used in children, last six to 18 months and typically fall out on their own. Long-term tubes typically used in adults are shaped like a T to stay in place longer.

How to Prepare

Ear tube placement in adults is a quick and relatively uncomplicated procedure. It is typically performed in your healthcare provider's office under local anesthesia and takes approximately 15 minutes.

Your healthcare provider will give you instructions to follow prior to the appointment. Most people are safe to drive after the procedure, but you may want to arrange for a ride just in case. Remember to bring your insurance paperwork and identification to the appointment.

What to Expect on the Day of Surgery

Ear tube placement is one of the most common procedures performed in the United States each year. In adults, it is performed in an otolaryngologist's office under local anesthesia and may be done in one or both ears.

Before the Procedure

After arriving at the healthcare provider's office, you will be brought back to the procedure room and may be given a gown to change in to or a waterproof drape to put over your clothes. Your healthcare provider will examine your ears and ask you to tilt your head so your ear is facing up and numbing drops will be placed in your ear.

During the Procedure

Once the drops have taken effect and your inner ears are numb, the healthcare provider will perform a myringotomy. This involves making a small hole in the eardrum with a scalpel or laser.

Once the incision is made, the healthcare provider may ask you to tilt your head so your ear is down to help the fluid drain. If there is a lot of fluid in the eardrum, your healthcare provider may use a small suctioning device to remove it.

Then the healthcare provider will use small forceps to gently guide the ear tube into place. If both ears require tubes, the procedure is repeated on the other side.

After the Procedure

Once the procedure is done, your healthcare provider may pack your ears with cotton to catch any additional drainage. If the procedure was performed due to hearing loss, your healthcare provider may perform an audiogram after the ears have drained to see if it helped.

You will be given instructions for aftercare and to schedule a follow-up visit in two to four weeks. Most people are able to drive themselves home after having ear tubes placed in-office.

Recovery

You may experience continued drainage and some mild pain in the days following ear tube placement. Be sure to follow your healthcare provider's instructions and call the office if you have any questions or concerns. Most people can return to school or work the day after having tubes placed, but recovery times vary between individuals.

Healing

Recovering from ear tube placement surgery is typically quick. Your healthcare provider may prescribe antibiotic ear drops to use following surgery that need to be taken for a few days after the procedure. Complete the full course of medication to avoid the development of antibiotic-resistant bacteria.

If you experience any discomfort, over-the-counter pain relievers, such as Tylenol (acetaminophen) or Advil (ibuprofen) should help. Over time, the eardrum will heal around the tube, helping to keep it in place.

Water Activities

Your healthcare provider will give you instructions regarding when it is safe to submerge your head underwater or get your ears wet. It is typically recommended to avoid getting water in your ears for the first week following the procedure.

According to the American Academy of Otolaryngology–Head and Neck Surgery, it is safe to swim and bathe with ear tubes after the initial healing period. Some otolaryngologists will recommend that you avoid getting water in your ear until months after the tubes have come out.

In the past, it was recommended to wear earplugs or otherwise keep water out of your ears for the duration of having tubes, however, research shows no benefit in keeping your ears dry. The tubes are very narrow—one-twentieth of an inch—and water does not appear to cause any issues. 

A Word From Verywell

Ear tube placement surgery in adults is a quick procedure with fast recovery time. However, the surgery is not always effective. Be sure to follow your healthcare provider's directions and schedule follow-up appointments. Most people need to be seen every six months to check on the tubes.