Ear tube placement is the most common outpatient surgery performed on children in the United States according to a recent study. It is a treatment plan for chronic middle ear infections.
In this Q&A, Aldo V. Londino, MD, and Stephanie Wong, MD, ear, nose and throat (ENT) experts at Mount Sinai, explain why ear tubes are important, the signs a child might need them, and what to expect from the surgery.
Stephanie Wong, MD
It is important to recognize the signs and symptoms early of chronic ear infections and to have your child looked at by a specialist early to avoid hearing loss, further infections, and future complications. If you have concerns, it’s best to contact your pediatrician.
What are ear tubes, and why do they help?
Ear tubes are small devices that are placed in the eardrum to allow better airflow and improved ventilation in the middle ear, allowing fluid to drain out. The middle ear space sits between the eardrum and the Eustachian tube, which connects the middle ear space to the nasal cavity. When that space is not ventilated, fluid gets trapped. The ear tube lets the fluid drain out, reducing future ear infections. It also allows sound to travel normally through the ear, allowing your child to hear better.
How do I know if my child needs ear tubes?
If your child has recurring ear infections—which means at least three infections within six months or four ear infections in a year—then ear tubes will likely help them feel better. If a child has had persistent fluid buildup in the ears, a hearing test may be recommended to determine if they have hearing loss. Sometimes ear tubes are also recommended if your child has had consistent middle ear fluid for several weeks.
What are signs to look out for?
- Recurrent middle ear infections from a cold or a respiratory illness that don’t clear up easily.
- Severe ear infections resulting in perforations of the eardrum.
- Earaches that get worse over time.
- Hearing loss or sound is muffled, and child may fail a hearing screening or test.
- Delay in speech development.
Aldo V. Londino, MD
What happens during ear tube surgery?
Ear tube surgery usually takes about 10 to 15 minutes. The surgery is done in an operating room while your child is under a short period of general anesthesia. This is an outpatient procedure, so the child goes home the same day. The surgeon will make a tiny incision in each eardrum, remove existing fluid from the middle ear, and insert the small tube into the eardrum. In one to two years, ear tubes usually fall out on their own because they are pushed out as the eardrum heals. Doctors typically monitor the tubes while they are in place during regular checkups. The placement of ear tubes usually allows hearing to return to the child’s normal baseline level. Children may temporarily experience sensitivity to loud sounds after tube placement. The tubes themselves rarely can cause mild low-pitch hearing loss, which resolves after the tubes fall out.
How do we take care of the ears after ear tube surgery?
Usually there is little to no pain after ear tube placement. If a child feels some pain, they can find relief by taking acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) pain relievers. You should ask your health care team for the appropriate dose for your child’s age and weight. Antibiotic eardrops are routinely prescribed following the surgery. These eardrops are used to treat future infections and sometimes to help keep the tubes open while things heal. A child can go on with routine activities after surgery.
Drainage from one or both ears is common for two or three days after surgery. This drainage is either clear or cloudy. On occasion, the drainage can be bloody or yellow, depending on how infected the ear was at the time of surgery. It’s also common to see drainage on the pillowcase the first day. Drainage beyond three days following surgery is unusual, and you should notify your doctor about this.
You should avoid getting any kind of water (such as during swimming) in the ear besides sink water, the first seven days after surgery. Beyond this time, water precautions are generally not required. However, a shower spray should not be directed straight into the ear canal. Older children who dive more than a foot or two under water should wear earplugs, as should those who soak in a tub with their ears under soapy bathwater. Do not use cotton for this; use special earplugs that mold to the bowl of the ear.
If you think your child should see an ENT or if you have concerns or questions, please call 833-4ENTKID (833-436-8543) to schedule an appointment.