Overview

Ear tubes are tiny, hollow tubes that surgeons place into the eardrums during surgery. An ear tube allows air into the middle ear and helps keep fluid from building up behind the eardrum. Ear tubes also allow fluid behind the eardrums to easily drain out into the external ear. The tubes usually are made of plastic or metal.

Ear tubes also may be called tympanostomy tubes, ventilation tubes, myringotomy tubes or pressure equalization tubes.

Ear tubes can help children who have repeated or long-lasting ear infections, called chronic otitis media. Ear tubes also may help children who still have fluid buildup in the ear after an infection clears up, especially if it is affecting their hearing. This is called otitis media with effusion.

Most ear tubes are made to fall out in 4 to 18 months. The holes heal on their own most of the time. Some tubes are meant to stay in longer. Healthcare professionals may need to remove ear tubes in a second procedure if they don't naturally fall out after 2 to 3 years. In some cases, the holes may need to be closed with surgery.

Why it's done

An ear tube, also called a tympanostomy tube, is used to treat and prevent the buildup of fluid in the middle ear.

The middle ear

The middle ear is the space behind the eardrum that has three tiny bones that vibrate. An opening in the middle ear leads to a tube that connects the middle ear to the back of the throat. This tube is called the eustachian tube. This tube has three jobs:

  • Keep air pressure even in the middle ear.
  • Bring fresh air to the ear.
  • Drain fluid from the middle ear.

The eustachian tubes of young children are narrower and more level than adults' eustachian tubes are. So they're harder to drain and more likely to get clogged.

Middle ear issues

Swelling, irritation and fluid buildup in the middle ear can lead to conditions that ear tubes can help treat.

Ear tubes might treat the following conditions:

  • Middle ear infection, known as acute otitis media. Bacteria or viruses cause this infection. It leads to inflammation and fluid in the middle ear. Ear tubes might help prevent new infections in children who have repeated ear infections and fluid in one or both ears. Children who have three or more infections in six months or four or more in a year also may be helped by ear tubes.

  • Buildup of fluid without infection, also called otitis media with effusion. This may be caused by fluid that stays in the ear after an infection. Other causes include issues with the eustachian tubes or another condition that keeps fluid from draining.

    Fluid buildup can cause hearing loss and balance problems. If fluid buildup lasts for three months or more, the healthcare team may do a hearing test and consider ear tubes. Ear tubes might help with hearing problems, speaking or learning concerns, balance problems, ear pain, behavior concerns, or trouble at school related to fluid buildup in the ear.

  • Ongoing middle ear infection, also called chronic middle ear infection. Children with this condition have repeated or long-lasting ear infections that may not get better with antibiotics or that continue to come back. Children with long-lasting ear infections, fluid in one or both ears, and other symptoms may have an ear tube procedure. An ear tube can drain the ear. It also can make a way for antibiotic drops to be put in the middle ear.
  • Ongoing inflammation of the middle ear, also called chronic suppurative otitis media. This inflammation causes a rupture in the eardrum and continuing drainage from the ear. An infection, a blocked eustachian tube or injury to the ear can cause the tear. An ear tube can help the ear drain after surgery to fix the eardrum. The tube also makes a way for ear drops to be put right into the middle ear.

Risks

Putting in an ear tube carries a low risk of serious complications. Possible risks include:

  • Bleeding and infection.
  • Fluid that keeps draining from the ear.
  • Blocked tubes from blood or mucus.
  • Eardrum scarring or weakening.
  • Tubes falling out too soon or staying in too long.
  • The eardrum not closing after the tube falls out or is taken out.

How you prepare

Ask your healthcare team how to get your child ready for surgery to place ear tubes.

Tell your healthcare team:

  • All medicines your child takes.
  • Your child's history or family history of bad reactions to medicines.
  • Known allergies or other reactions to other medicines, such as medicines to fight infections, known as antibiotics.

Questions to ask a member of your healthcare team include:

  • When does my child need to start fasting?
  • What medicines can my child take before surgery?
  • When should we arrive at the hospital?
  • Where do we need to check in?
  • What is the expected recovery time?

Tips for helping a child prepare include the following:

  • Start talking about the hospital visit a few days before the appointment.
  • Tell the child that ear tubes can help make ears feel better or make it easier to hear.
  • Tell the child about the special medicine that helps the child sleep during the surgery.
  • Let the child pick out a favorite comfort toy, such as a blanket or stuffed animal, to take to the hospital.
  • Let the child know you'll stay at the hospital while the tubes are being placed.

What you can expect

An ear, nose and throat specialist places ear tubes, also called tympanostomy tubes, during an outpatient procedure.

Before the procedure

Young children usually receive medicine to put them to sleep for the procedure, called general anesthesia.

The risks of this medicine are low in healthy children. But possible effects of general anesthesia include:

  • Upset stomach or throwing up after the surgery.
  • Trouble breathing.
  • Allergic reaction.
  • Irregular heartbeats.

Your child's care team may offer other anesthesia options in some cases.

During the procedure

The procedure usually takes about 15 minutes. The ear, nose and throat specialist:

  • Makes a tiny hole in the eardrum with a small scalpel or laser. This is called a myringotomy.
  • Uses suction to remove fluid from the middle ear.
  • Places the tube in the opening in the eardrum.

The team doing the procedure uses tools to watch the child's heart rate, blood pressure and blood oxygen during the procedure.

After the procedure

After the procedure, children are moved to a recovery room. The healthcare team watches for any issues. Children who have no problems usually go home in a few hours.

Children might be sleepy and cranky for the rest of the day. Occasionally, they might feel like throwing up. Most often, children can go back to their regular activities within 24 hours of the surgery.

Follow-up care

Ask your child's healthcare professional about follow-up care after ear tubes are in. If there are no issues, care may include the following:

  • Follow-up appointments. Your child may meet with the surgeon or other healthcare professional after a few months. The healthcare professional may look at your child's ears and the tubes. Your child may have regular follow-up appointments until the tubes fall out.
  • Ear drops. A healthcare professional may suggest ear drops in some cases if there is drainage or infection. Children who use these drops need to use all the medicine as directed. That's true even if there's no fluid coming from the ear or other symptoms of infection.
  • Hearing test. This is also called an audiogram. For children who had hearing loss before getting ear tubes, a healthcare professional will order a test to check hearing afterward.
  • Earplugs. Most children don't need to wear earplugs while swimming or bathing unless a healthcare professional says to do so.

When to contact your doctor

Reasons to see your child's ear, nose and throat specialist outside of scheduled follow-up appointments include:

  • Yellow, brown or bloody discharge from the ear that lasts for more than a week. This can be treated with antibiotic ear drops.
  • Ongoing pain, hearing problems or balance problems.

Results

Ear tubes may:

  • Lower the risk of ear infections.
  • Improve hearing.
  • Help with speech.
  • Help with behavior and sleep problems related to ear infections.

Even with ear tubes, children can get some ear infections.

By Mayo Clinic Staff