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Myringotomy and/or Tympanostomy
Ear Tubes in Adults

When medical therapy is ineffective, tympanostomy tubes (ear tubes) may be recommended for the treatment of chronic ear fluid, recurrent ear infections, and some types of hearing loss. Tympanostomy tubes might also be recommended for problems with pressure and "popping" of the ears, usually from allergies or exposure to altitude changes. Alternatively, the physician might recommend only a myringotomy (ear opening) without tube placement. This means that an opening is made in the eardrum, but a tube is NOT placed through the eardrum.  The eardrum usually heals on its own after a few days if no tube is placed.

A myringotomy is usually done in the office, by using a local anesthetic to numb the eardrum. A small incision is made in the eardrum, which allows drainage of ear fluid. Sometimes the physician then inserts a tube into the eardrum. Whether or not a tube is placed depends on the underlying cause and duration of the symptoms.

Tympanostomy tubes usually stay in place 6 to 12 months and fall out as the eardrum regenerates. The tubes are not visible . Initially, there may be a sensation of hearing one's own voice and/or pressure, but this usually goes away with time. Ear tubes reduce the severity and frequency of infections, fluid, and hearing loss, but cannot reverse the underlying reasons for the ear disease (allergies, eustachian tube dysfunction etc.).

The ear tubes work by ventilating the middle ear (the space behind the eardrum) and improving function . When the tubes are in place, it is possible for patients to have drainage when they get "colds" or allergy symptoms. (If this persists beyond 2-3 days or is accompanied by fever, the physician should be notified because ear drainage may be a sign of ear infection).

Placement of ear tubes has few risks. When the tubes fall out, less than 5% of patients will have a small hole in the eardrum (perforation) that could require additional surgical repair. Some patients develop frequent drainage from the ear that requires antibiotic treatment.

A follow up visit with the physician is scheduled after surgery so a hearing test can be done and the ear tubes evaluated. Usually the patient is seen every 6 months until the tubes fall out. This is important to ensure that the eardrum heals properly and hearing loss is resolved.

Instructions After the Procedure

• It is not unusual to have ear drainage after surgery. Sometimes this drainage can be bloody, which can be a sign of inflammation. The antibiotic drops (if prescribed) should be continued as directed and the cotton ball changed as often as needed.
  
• Mild ear pain may require treatment with Tylenol.
  
• Normal activity can usually be resumed the day of the procedure. Most people are able to drive home from the office. Very few patients feel lightheaded or "dizzy." Should this persist, someone may be required to pick the patient up.
  
• Water should be kept out of the ears for 5-7 days. Placing a cotton ball covered with Vaseline Petroleum jelly in the ear canal can do this. If some water does enter the ear and cause pain, use Tylenol as needed. This is not necessarily a sign of infection. Avoid the use of Q-tips.
  
• Usually, earplugs are not needed during swimming and other chlorinated water exposure while the tubes are in place. Swimming in a lake, river, or ocean water is more risky. The physician will advise the patient if earplugs are recommended.