Information for Parents About Ear Tubes

Myringotomy surgery and insertion of synthetic ear tubes, also called myringotomy tubes or ventilation tubes, are used to treat and prevent chronic ear infections or fluid in the ear. 

Why Your Child Might Need Ear Tubes

Ear infections can occur when the Eustachian tube (also called an auditory tube) becomes swollen and no longer ventilates the middle ear, leading to fluid and sometimes infection in the middle ear.

Children are more likely to experience chronic ear infections because their Eustachian tubes are at a more horizontal angle, shorter and narrower than that of adults. A myringotomy is a small incision in the tympanic membrane (eardrum). This incision allows fluid and pus to drain from the middle ear and relieves pressure.

Ear tubes are tiny tubes made of plastic or metal which will allow fluid and bacteria to continue draining. They are placed after the myringotomy is made. Leaving these synthetic tubes in place facilitates ongoing ventilation of the middle ear and prevents future infections or problems caused by fluid in the ear. Without ear tubes, the myringotomy incisions would close up within a couple of days.

Indications

Insertion of ear tubes can help treat and prevent a variety of middle ear disorders. The most common reason for ear tube insertion is for the treatment of chronic ear infections.

Other reasons are:

• Improve severe symptoms of ear infections
• Hearing loss that's related to excess fluid in the middle ear
• Speech problems related to fluid in the ear

How Ear Tubes Are Placed

Ear tubes are usually placed in a same-day surgery setting. This could be in a hospital or a surgical center. Before the surgery, you will receive instructions about how to prepare.

Preparation

Your child's doctors will need a complete health history and a list of any medications that your child has been taking. Medications that can cause bleeding, including nonsteroidal anti-inflammatories (NSAIDs), vitamin E, and some other herbal supplements may need to be stopped before the procedure. Make sure you follow the exact instructions provided for your child.

Inform your healthcare provider and the surgical center of any allergies your child has and if they have ever had an abnormal reaction to anesthesia. If your child drinks from a bottle or special cup, make sure you bring it along. It's also a good idea to bring a "comfort item" such as a pacifier, blanket, or favorite stuffed animal.

Your child will not be allowed to eat or drink after midnight the night before surgery. This reduces the risk of aspiration of stomach contents into the lungs while under anesthesia.

During Surgery

The surgery is short, on average lasting half an hour or less. Your child will be sedated and should not experience any pain. For some kids, the combination of anesthetic drugs and the unfamiliar environment can make them feel anxious.

You will need to remain at the hospital for a short while after the procedure is completed Your child's temperature, blood pressure, heart, and respiratory rates, and oxygenation will all be monitored while they recover from the sedation.

What to Expect After Surgery

Before you leave the hospital, you will receive a comprehensive set of instructions explaining how to care for your child after surgery. It is important to follow these instructions carefully. Generally speaking, most children can return to normal activities a day or two later.

You may be instructed to keep water out of the ears for a few days after surgery.

While swimming and bathing without earplugs used to be prohibited for the entire time the synthetic ear tubes were in place, this is no longer recommended. Your child may be able to bathe and swim as they normally would a few days after the procedure. You should check with the surgeon regarding their guidance for water precautions.

Will the Tubes Need to Be Removed?

No. As your child grows, their Eustachian tube will grow as well. With time, the synthetic tube will become loose and fall out on its own. This is normal. The incision will heal on its own shortly after.

Occasionally a new set of tubes will need to be placed, but often the growth of the Eustachian tube will be sufficient to prevent your child from experiencing chronic ear infections again. In some rare cases, the ear tubes can become stuck in the eardrum. In this case, the surgeon may decide to remove the old ear tubes and place a new set at the same time.