Tympanostomy Tubes

What are tympanostomy tubes (also called ear tubes, myringotomy tubes, or ventilation tubes)?

Tympanostomy tubes are small tubes that are surgically placed into your child's eardrum by an ear, nose, and throat (ENT) surgeon. The tubes may be made of plastic, metal, or Teflon®. The tubes are placed to help drain the fluid out of the middle ear to reduce the risk of ear infections. During an ear infection, fluid gathers in the middle ear, which can affect your child's hearing. Sometimes, even after the infection is gone, some fluid may remain in the ear. The tubes help drain this fluid, and prevent it from building up. The most common ages for tube placement are from 1 to 3 years old. By the age of 5 years, most children have wider and longer eustachian tubes (a canal that links the middle ear with the back of the nose), thus, allowing better drainage of fluids from the ear.

Who needs ear tubes?

The insertion of ear tubes may be recommended by your child's health care provider and/or a specialist in children with:

  • Fluid in both ears for 3 or more months and hearing problems
  • Fluid in 1 or both ears for 3 or more months and problems related to the presence of the fluid (such as trouble with balance, ear pain, or problems in school or with behavior, repeated infections with fluid in one or both ears that is unlikely to go away quickly)

What are the risks and benefits of ear tubes?

The risks and benefits will be different for each child. It is important to discuss this with your child's health care provider and surgeon. The following are some of the possible benefits that may be discussed:

  • Ear tubes may help to reduce the risk of future ear infections.
  • Hearing is restored in some children who experience hearing problems.
  • Speech development is not harmed.
  • Ear tubes allow time for the child to mature and for the eustachian tube to work more efficiently.
  • Children's behavior, sleep, and communication may be improved if ear infections were causing problems.

The following are some of the risks that may be discussed:

  • Some children with ear tubes continue to develop ear infections.
  • There may be problems with the tubes coming out:
    • The tubes usually fall out in about one year. After they fall out, if ear infections recur, they may need to be replaced.
    • If they remain in the ear too long, the surgeon may need to remove them.
    • After they come out, they may leave a small scar in the eardrum. This may cause some hearing loss.
  • Some children may develop an infection after the tubes are inserted.
  • Sometimes, after the tube comes out, a small hole may remain in the eardrum. This hole may need to be repaired with surgery.

How are ear tubes inserted?

Tympanostomy is the surgical procedure to insert ear tubes. This is usually an outpatient procedure. This means that your child will have surgery, and then go home that same day. Before the surgery, you will meet with different members of the health care team who will be involved in your child's care. These may include:

  • Nurses. Nurses help prepare your child for surgery. Operating room nurses assist the surgeon during the procedure. Recovery room nurses care for your child as he or she recovers from general anesthesia.
  • Surgeon. A specialist who places the tubes.
  • Anesthesiologist. A specialist who gives anesthesia and monitors your child during surgery.

This procedure involves making a small opening in the eardrum to drain the fluid and relieve the pressure from the middle ear. A small tube is placed in the opening of the eardrum to allow air to flow into the middle ear and to prevent fluid from building up. The child's hearing is usually restored after the fluid is drained. The tubes usually fall out on their own in about a year. Your child will be monitored closely. Most children can go home in an hour or 2 after surgery.

Follow-up as recommended by your child's surgeon.

Care of the child after the ear tubes are inserted

The following are some of the instructions that may be given to you following the placement of ear tubes in your child:

  • Ear drops may be prescribed.
  • Call your child's surgeon if your child has the following symptoms:
    • Drainage from the ear after the first few days or increased drainage from the ears
    • Ear pain
    • Fever
    • Displaced ear tube
  • Ear plugs for bathing or swimming may be recommended.