Ear Tube Insertion

According to the American Academy of Otolaryngology, ear tube insertion is the most common childhood surgery performed with anesthesia. The procedure is usually performed because of bacteria that travel from the nasal cavity into the ear during a cold or other respiratory ailment. This influx of bacteria stimulates inflammation and causes a fluid buildup behind the eardrum.

Adults can also get ear infections, but children get them more frequently because they have smaller eustachian tubes that are more likely to clog. The National Institute on Deafness and Other Communication Disorders says that five out of six children will have at least one ear infection by their third birthday.

Ear infections will often go away with time, but antibiotics can treat them effectively as well. Sometimes, however, a person will experience recurrent ear infections and fluid buildup, or have an ear infection that won’t heal for months. These issues can cause problems that may lead to hearing loss, behavioral issues, and speech development delays in children.

Individuals who suffer from severe ear infections that spread to nearby tissues and bones, or experience a pressure injury from flying or deep sea diving may also require an ear tube insertion.

For the insertion, an otolaryngologist (ear, nose, and throat doctor) places tiny plastic or metal tubes in the eardrum. Once inside the ear, these tubes will:

• Reduce pressure. Ear infections and fluid buildup increase pressure inside the ear, which is what causes pain. Ear tubes allow air to enter the ear, equalizing the pressure between the inner ear and the outside world. This eases pain and helps prevent accumulation of liquid in the middle ear.
• Drain fluid. Ear tubes allow pus and mucus buildup from ear infections to drain out of the ear without causing pain or increasing the risk of related complications.
• Prepare the ear for treatment drops. Tubes also make it easier to use antibiotic drops in the ears to treat infections. The tubes function as a passageway, permitting the drops to travel directly into the ear. Because they make antibiotic drops easier to use, the tubes can eliminate the need for oral antibiotic treatment.

Ear tube insertion, also called myringotomy and tympanostomy tube placement, is a very common procedure performed under general anesthesia. During the procedure, the patient is asleep and breathing on their own. The surgical team monitors heart rate, blood pressure, and blood oxygen throughout the surgery.

The actual surgery takes only about 10 to 15 minutes. During this time, the surgeon performs the following steps:

• Makes an incision. The surgeon makes a tiny incision in the eardrum with a small scalpel or laser. If left alone, this incision would close and heal within a few days.
• Removes fluid. Using a tiny vacuum, the surgeon suctions out any excess fluids from the middle ear, cleaning out the area. This is called aspiration of the middle ear. Your doctor will determine if this step is necessary.
• Inserts the tube. To allow air to enter your ear and to drain fluids, the surgeon inserts the tiny tube into the hole made by the incision. The surgeon may place short-term tubes, which are smaller and remain in the ear for 6 to 12 months before falling out on their own, or long-term tubes, which are larger and typically stay in place for a longer period of time.

Ear tube insertion is a common and safe procedure. On rare occasions, however, complications may occur. Check with your doctor if you:

• experience a fever of 102 degrees Fahrenheit or higher
• notice green, pus-like drainage coming out of your ear for more than a week
• experience persistent pain or continuous bleeding (some bleeding on the first day after surgery is common)

After the surgery, patients typically stay in the recovery room for a short time and leave the hospital on the same day. To reduce your chances of infection, the doctor may prescribe antibiotics or eardrops, and you may use over-the-counter pain relievers for any discomfort.

Your doctor may also recommend that you cover your ears when bathing or swimming to help reduce the risk of bacteria entering the middle ear. Earplugs and other watertight devices work well.

Otherwise, the ear will heal by itself, securing the tubes in place until they eventually fall out. If the tubes fall out prematurely, be sure to contact your doctor.

The good news is that after surgery, most people experience far fewer ear infections and recover faster from any infections they do get. They also sleep more soundly, hear better, and feel better in general.