In patients who have recurring ear infections or those who have fluid that remains in place for months without resolving your ENT physician may suggest putting in tubes. This are sometimes referred to as pressure-equalizing (PE) tubes or tympanostomy tubes. Ear tubes allow air to enter the middle ear and allow fluid to drain. Tubes do not prevent ear infections, they decrease the risks associated with ear infections—pain, decreased hearing, scarring which can lead to hearing loss later in life, antibiotic resistance. This surgery requires general anesthesia for children but can often be done in the office under local anesthesia for adults. The surgeon makes a small incision (myringotomy) in the ear drum and then inserts a small tube into the eardrum. The tube keeps the incision from closing, allows fluid behind the eardrum can drain out, and the ear to equalize pressure. You will not be able to see the tube. Most ear tubes extrude on their own over 6-18 months.
What to do BEFORE surgery
Here are a few things you can do before surgery to help things go more smoothly:
- Eliminate ALL medications that thin your blood for two (2) weeks before surgery, unless directed otherwise by your surgeon. Please see this list. (hyperlink)
- If you (or your child if they are the patient) develop a fever or chest cold 5 days prior to surgery please notify us. A cold may increase the risk from anesthesia.
- No food (including milk) 8 hours prior to surgery. No liquids for 4 hours prior to surgery.
- Arrange for a ride home after the procedure.
What to Expect During Surgery
In most cases surgery is performed under general anesthesia. With general anesthesia, you (or your child) will be asleep for the entire surgery. Surgery typically lasts less than 15 minutes. When your surgery is over, you (or your child) will spend time in the recovery area. Most children are upset, confused when they wake up from the anesthesia. This typically passes quickly. Loud noises may be startling or cause some mild discomfort at first.
What to expect AFTER surgery
Ear drops will be prescribed for use for 5-7 days after surgery.
For the first month after surgery we recommend keeping the ears dry. This includes during bath time. Ear plugs or cottonballs topped with Vaseline prevent water from entering the ear canal.
Most patients have very little discomfort, and often feel better, after surgery. If needed over the counter medications such as Tylenol may be used.
You (or your child) should be seen in the office 3-4 weeks after surgery to see how the ear is healing and every 6 months while the tubes remain in place. If any drainage from the ear develops after the initial postoperative period please notify our office.
What are the risks of Surgery?
As with any surgical procedure, ear tubes has associated risks. Although the chance of a complication occurring is small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.
Eardrum perforation (hole): Most of the time when the tube comes out the eardrum heals itself here the tube was. In 3-5% of cases the eardrum does not heal on its own. If this occurs, the hole can be repaired if needed.
Infections: Ear tubes do not prevent ear infections but prevent the complications of ear infections. If an infection occurs there will be drainage from the ear. Drainage can be pink, clear, yellow, green, brown, or bloody. Please notify us if there is any drainage. With tubes in place ear infections are typically easier to treat, cause less pain and hearing loss.
Persistent eustachian tube problems: Up to 5-10% of patients undergoing a first set of tubes, will need a second or more sets of tubes. The decision for each set of tubes is dependent on the circumstances at that time. If a second set of tubes (or more) is needed, other medical conditions are also typically investigated.
Retained tube: On occasion a tube will remain in the eardrum more than a year. That is OK. If a tube lasts more than 2-2 ½ years however, we will probably suggest surgical removal. This is because the perforation rate increases after 2 years.