Tympanostomy tubes are tiny tubes that are placed in the eardrum. Also called "ear tubes", they are usually placed for these reasons:
- If your child has repeated ear infections that do not get better with antibiotics
- If your child has fluid in his or her middle ear space for 3 months or more
The middle ear space is normally filled with air. If the middle ear is filled with fluid instead of air, hearing is muffled or garbled. This is what happens with ear infections. By draining fluid, tympanostomy tubes allow the middle ear to fill with air again and ventilate properly.
The main concern about fluid in the ear is that it makes sound garbled. This can interfere with your child's learning to speak because children imitate the sounds they hear. Hearing usually improves soon after the tubes are placed. Your doctor or an audiologist should check to make sure that your child's hearing is normal.
How are Tubes Placed in Your Child's Ears?
Tubes are placed during surgery. Most children will go home the same day of the surgery. Your child is briefly put to sleep during the procedure. When you schedule the surgery, we will tell you that your child cannot ear or drink (including water) for a certain number of hours before the surgery. It is very important to have an empty stomach so that he or she doesn't vomit and inhale it in while asleep.
After you child is asleep, your doctor makes a tiny surgical opening under a microscope in your child's eardrum. Any fluid present in the middle ear is then suctioned out. Next, the tube is put in the small opening in the eardrum. Most tubes look like a small spool, generally the size of the tip of a pen.
It is normal for your child to be tired, irritable or feel sick to his or her stomach for a few hours after surgery. If your child continues to feel sick or vomits after you go home, call your doctor. There may be persistent watery ear drainage, sometimes blood-tinged, for the next 48 hours. This is normal.
When your child is ready to eat, offer clear liquids such as juice, broth, or popsicles, and if tolerated offer a light diet such as toast, crackers, or applesauce. When your child eats these foods without problems, he or she can resume a normal diet.
Most children resume their normal routine shortly after surgery. Watch for unsteadiness during the first 24 hours after surgery. If your child does seem unsteady or dizzy, encourage quiet activities such as reading, watching TV or coloring. Traveling by airplane or to the mountains (elevation changes) will not hurt your child's ears.
More Ear Infections?
Although the risk is lowered, ear infections can still happen, usually occurring with a cold. Infections may start with drainage, but generally have little (or no) pain or fever. The drainage is usually thick and sticky with noticeable odor. Call your doctor if this happens. Most infections can be successfully treated with ear drops alone.
Water Precautions After Surgery
After tubes are placed, some children may get ear infections from water entering the ear canal and going through the tube. This seems to happen more often with older children. To protect the ears from water take a piece of cotton, place it snugly in the outer ear, then cover it generously with Vaseline to make it waterproof. Some studies have shown that water precautions are not needed for babies. Your doctor may suggest:
- Sometimes protect the ears from water. Use the cotton plugs if your child tends to submerge his or her head and ears while bathing or swimming
- Always protect ears from water while bathing or hair washing. Follow the instructions above for using cotton plugs. Custom ear plugs are also available
Some children are more susceptible to ear infections with even little water exposure and should always use water precautions. If incidental water enters your child's ear, use drops given to you after surgery and place 5 drops in that ear.
Please schedule a follow up visit for 2-3 weeks after surgery. Further follow up visits are needed for every six months thereafter. Your child's ears need to be examined regularly for the status of the tube and health of the middle ear.
The tube will work its way out of the eardrum and into the ear canal on its own. This usually happens 6-12 months after surgery. In most children the remaining hole in the ear drum will slowly close. Less than 20% of all children with tympanostomy tubes need a second set of tubes.
Call Your Doctor If...
- An ear infection develops after surgery and can not be successfully treated by your family doctor or pediatrician
- If you have any other questions
Q. What are Tympanostomy tubes?
A. Tympanostomy tube is a tiny tube that is inserted through a small hole in the eardrum to allow air to get into the middle ear. The tubes come in many different shapes and sizes and are usually made of plastic or metal.
Q. Why does my child need tubes?
A. Some children develop frequent middle ear infections or retain fluid in the middle ear because the Eustachian tube, a tube that connects the middle ear to the throat, isn't working well enough to allow air to pass into the middle ear. Ear infections can be very painful and fluid in the middle ear can impair hearing and speech development. Placement of a tube can help these problems by allowing air to enter and permitting fluid to drain out.
Q. After tubes are placed, will my child still get ear infections?
A. Some children with tubes still get middle ear infections, but they are less common and are rarely painful. Children with tubes who get middle ear infections usually have visible pus or drainage in the ear canal. If this happens to your child, bring him/her to the doctor? The infection can be easily treated in most cases.
Q. How long will my child need the tubes?
A. Usually tubes remain in place for 9 to 12 months. Generally the tubes will fall out by themselves and the holes will heal up. Most children will eventually outgrow the tendency to develop middle ear infections and will no longer need the tubes. If your child continues to have frequent middle ear infections, it is possible that your physician will recommend replacing the tubes.
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