Each year nearly half a million ear tube surgeries are performed on children, making it one of the most common childhood surgeries performed with anesthesia. The typical age for insertion of ear tubes is from six months to three years.
Inserting tubes reduces the risk of future ear infections, restores hearing loss caused by fluid behind the eardrum, improves speech and balance issues and often improves a child’s behavior and sleep issues caused by a chronic ear infection.
Ear tubes are tiny cylinders placed through the eardrum (tympanic membrane) that permit air into the middle ear. They are also called ventilation tubes or pressure equalization tubes. The tubes allow the pressure to be the same on both sides of the eardrum.
Ear tubes are made out of plastic, metal, or Teflon and sometimes have a coating to reduce the possibility of infection. There are two types of tubes: short-term and a long term. Short term tubes are more common and typically stay in place for six months to a year before falling out on their own. Long-term tubes are typically larger and have flanges that secure them in place. Long-term tubes may fall out on their own but often require removal by an ear, nose and throat doctor.
Ear tubes are recommended when a person experiences repeated middle ear infections (acute otitis media) or has a hearing loss caused by persistent fluid in the middle ear. These conditions typically occur in children but can also be present in adults. Sometimes fluid in the middle ear can lead to speech and balance problems, hearing loss or dizziness. Other less common reasons that may require tube placement are malformations of the eardrum, Down Syndrome, cleft palate or barotrauma due to changes in atmospheric pressure experienced when flying or scuba diving.
In children, ear tube surgery is done as an outpatient procedure using a light general anesthetic. A tiny incision is made in the eardrum using a microscope for vision. Any fluid behind the eardrum is suctioned out. A tiny tube is then placed in the incision and ear drops are instilled. The procedure lasts less than 15 minutes, and the child awakens very quickly. Following the procedure, your child will be monitored in the recovery room and go home within an hour. Children typically experience a little or no postoperative pain. They may be temporarily groggy from the anesthetic. Your child will typically use antibiotic ear drops for 3 to 7 days and typically follow up within a week or two in the office. Children typically return home, take a nap and wake up hearing and feeling better.
Sometimes children who have had previous tube placement may also undergo an adenoidectomy (lymphoid tissue behind the nose). Research indicates that removing adenoid tissue in children with previous tube may reduce the risk of further ear infections.
It is essential to keep your child’s ears dry while bathing or swimming. Also, rivers, lakes, and streams can be highly contaminated, and it is important to be even more careful keeping their ears dry in these environments.
Possible complications from this surgery include a perforation in the eardrum that does not close when the tubes fall out. Should this occur, a procedure to patch the perforation would be required. In addition, it is possible for the tubes to come out earlier than expected and require a repeat surgery to replace the tubes. Tubes may remain longer than expected and require removal in the operating room. Finally, scarring can occur on the eardrum, however this rarely leads to any clinical problem with hearing.