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Tympanostomy Tubes
Ear Tubes in Children

When medical therapy is ineffective, tympanostomy tubes (ear tubes) may be recommended for the treatment of chronic ear fluid, recurrent ear infections, and hearing loss. The procedure is painlessly done while the child is asleep under general anesthesia, which is supervised by an anesthesiologist. The procedure is usually performed in day surgery and takes about 15 minutes. A small incision is made in the eardrum, which allows insertion of the tube into the eardrum. Eardrops may be needed after surgery.
Tympanostomy tubes usually stay in place from 6-18 months and fall out as the eardrum regenerates. The tubes are not visible, and the child does not feel them. Ear tubes reduce the severity and frequency of infections, fluid, and hearing loss, but cannot reverse the underlying reasons for the ear disease (young age, smoke exposure, allergies, etc). The ear tubes work by allowing drainage of fluid behind the eardrum and improving function of the middle ear (the cavity behind the eardrum). When the tubes are in place, it is not unusual for children to have drainage when they get "colds" or allergy symptoms. (If this persists beyond 2-3 days or is accompanied by fever, the surgeon 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 on their own, less than 5% of children will have a small hole in the eardrum (perforation) that could require additional surgical repair. About 1 out of 6 children develop recurrent drainage from the ear that requires antibiotic treatment. Most children only need tubes placed once, but about 15% may need multiple sets of tubes.
A follow up visit with the surgeon should be scheduled 2-3 weeks after surgery so a hearing test can be done and the ear tubes evaluated. Usually the child can be 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 should be continued as directed and the cotton ball changed as often as needed.
  
• Mild ear pain or pulling at the ears may require treatment with Tylenol.
  
• Fever up to 101 degrees Fahrenheit may sometimes occur and should be treated with Tylenol and plenty of fluids. If fever> 101 F persists, please call the office.
  
• Clear liquids (Sprite, water, Jell-O) are recommended for the first few hours after surgery, after which regular diet is usually OK. If nausea/vomiting occurs, hold food and liquid for 2 hours, then resume a clear liquid diet. If this does not resolve, please call the office. Please be prepared with the patient's date of birth and a pharmacy telephone number.
  
• Normal activity (including daycare) can usually be resumed the day after surgery.
  
• Water should be kept out of the ears at least until the first visit. This can be done by placing a cotton ball covered with petroleum jelly in the ear canal. 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.
  
• The surgeon will notify you if earplugs will be needed during swimming and other water exposure while the tubes are in place. In general, soapy bathtub water and lake water should be kept out of the ear while tubes are in place.

Please call your physician at (972) 402-8404 if you have concerns or questions.