What are ear tubes?

Ear tubes are tiny plastic tubes that are placed in the ear drum to serve several purposes. Ear tubes are often offered as treatment for children with chronic and recurrent ear infections.

First, they allow pressure to equalize between the middle ear and outside world similar to the job done naturally by the Eustachian tube. This helps to prevent accumulation of liquid in the middle ear and its effects on hearing and risk of infection.

Second, the tubes allow infection to drain out of the ear without causing severe ear pain and the rare but serious risks of ear infections.

Third, they allow us to treat any infections directly by using antibiotic drops that go into the ear canal rather than a prescription by mouth.

Tubes normally fall out on their own approximately nine to 12 months after placement. Most children do not require tube replacement unless they begin having fluid build up or recurrent ear infections again.

How are ear tubes placed?

We call the procedure myringotomy and tympanostomy tube placement.

This procedure is performed under general anesthesia, with your child totally asleep but breathing on his or her own and usually with only a mask and not a breathing tube.

Using a microscope, it takes five to 10 minutes to place most tubes by placing a tiny incision in the ear drum, using a tiny vacuum to remove any accumulated fluid or infection in the middle ear and then inserting the tiny plastic or silastic tube.

Does it hurt?

Yes, but only moderately for the first afternoon. We recommend acetaminophen (Tylenol) to help with the pain.

What should I expect during my child’s recovery?

• Nausea/vomiting: Some children are sensitive to the anesthesia medicines. This can last for 24 hours after surgery.
• Bloody ear drainage: It is common for there to be bloody drainage from the ear the first day. This blood can clog the new ear tubes. This is why we sometimes prescribe eardrops to use twice daily for the first three days to prevent clogging of the tubes. Any continuous bleeding or bloody drainage that starts several days, weeks, or years after the tubes are placed should be examined by the doctor. Call the doctor’s office for an appointment.
• Fever: Most children will have a low-grade temperature (up to 100°F) after this surgery and some will even have a fever (up to 101.5°F). If your child has a fever of 102° F or more, please report this to the doctor’s office.
• Diet: Your child can eat anything that he or she wants.
• Activity: When your child feels well enough to return to daily activities, then he or she is permitted. Some children are ready the same afternoon. Others need a day or two. They can immediately resume playground activities, physical education class, or sports teams when they are interested.
• Bathing: When bathing, be careful not to get tub water in the ears. It contains germs that can cause an infection. If tub water gets into the ears, please use the eardrops twice daily for three days after.
• Swimming:
  • In pools: Pool water is heavily chlorinated and usually doesn’t cause an infection. If your child simply splashes around in the water, then there is no need to wear earplugs. If your child swims underwater more than one-foot deep and complains of ear pain or drainage, then you may want him or her to wear earplugs to keep water out of the middle ear space.
  • In ponds, lakes, or the ocean: Pond, lake and ocean water contains germs that can cause ear infections, much like bath water. Your child may need to wear earplugs if they have pain or drainage after swimming in the ocean, lake, or pond.

What problems should I report to the doctor’s office?

Call your doctor's office if your child experiences any of the following:

• A temperature of more than 102°F
• Green pus-like drainage
• Continuous bleeding or new onset bleeding