Does your little one often have ear problems, take him to the doctor and get medicine, only to have the same problem come back a few days later? Or does the ear fill with water and your child feels like he has lost his hearing? You must be very worried about things like this. As a solution to such problems, doctors sometimes say that they need to "put a tube in the ear." That's what we're talking about today.
Simply put, what is a tympanostomy?
Ear tube placement, or in medical terms, a tympanostomy, is a minor surgical procedure performed by an ear, nose, and throat (ENT) specialist. It involves inserting a very small, hollow cylinder-like tube made of plastic or metal into your (or your child's) eardrum (the tympanic membrane or eardrum).
This is a very common surgery performed among children, but there are cases where these tubes can also be inserted in adults if necessary.
Why do we need to put a tube like this in our ears?
Imagine, we have a middle ear. Normally, this middle ear should have air in it. But sometimes it fills with a fluid like water. Or it gets infected. This is when tubes need to be inserted.
Some of the main reasons are:
- Frequent middle ear infections (acute otitis media): Some children develop ear infections every few months. This requires frequent antibiotics . Tube placement can help control this condition.
- Middle ear effusion: If there is a build-up of fluid in the middle ear for more than three months without any pain or fever, it can affect your child's hearing. A tube may be inserted to drain the fluid.
- Barotrauma: This is common among adults. For example, when the pressure changes during flights or mountain climbing, severe pain in the ear may require the insertion of tubes to control the pain.
This tube has two main functions. One is to create a path for the fluid trapped in the middle ear to drain out. The other is to allow air from the outside to enter the middle ear, preventing it from filling up again.
If these conditions are left untreated, children may experience delays in their ability to speak or even permanent hearing loss.
How is this surgery performed?
This is not as big a task as you might think, and it is usually completed in a very short time, about 15 minutes.
- Anesthesia: Children are usually given general anesthesia . This means that the child does not feel anything during the procedure, and is asleep. Adults can sometimes have this procedure done with only the ear numbed (local anesthesia) .
- Process:
1. First, the doctor makes a very small incision in the eardrum. This is also called a myringotomy .
2. Next, all the fluid trapped in the middle ear is suctioned out with a small instrument.
3. Finally, the small tube is inserted into that small incision.
This is done in a hospital operating room, and you can go home a few hours after the surgery. There is no need to stay in the hospital.
If some children have this problem frequently, the doctor may recommend an operation to remove the adenoids (adenoidectomy) at the same time as this surgery. The adenoids are a piece of tissue located behind our nose, above the upper palate. Removing these may reduce the need for ear tubes in the future.
What should I be careful about after surgery?
After the surgery, you will need to stay in the recovery room for a while. The anesthesia may cause you to feel a little sleepy and feel nauseous . This is normal.
Your doctor will examine you. They may prescribe antibiotic ear drops to help prevent infection. They may also recommend earplugs to keep water out of your ears when you shower or swim.
After that, you need to see the doctor every few months to check if the tube is working properly.
How long is the tube in the ear?
The tube usually falls out on its own within 9 to 18 months. The eardrum heals around the tube and pushes the tube out. If the tube has not fallen out after about two years, your doctor can remove it with a small procedure.
| Advantages and disadvantages of tube placement | |
|---|---|
| Advantages | Possible risks (Risks/Side Effects) |
| Reducing the need for frequent oral antibiotics for ear infections. | The hole in the eardrum that has formed after the tube is removed does not close (this may require further surgery). |
| Even if you have an ear infection, the pain and fever will decrease. | Scarring of the eardrum. |
| Restoration of lost or diminished hearing. | Ear infections recur even after tubes are inserted. |
| Improving the child's speech development. | The tube may come off quickly or not come off at all. |
| Reducing sleep problems caused by ear problems. | A condition called continuous fluid drainage from the ear (otorrhea). |
When should you call the doctor?
When you go home after surgery, there are a few things you should be aware of. If you experience any of the symptoms below, call your doctor right away.
- Ear pain that does not subside despite taking medication.
- Fever or chills.
- Bleeding from the ear.
- After the first few days, there may be more fluid coming out of the ear.
If you or your child have persistent ear problems (infections, pain, hearing problems) like these, tube placement surgery may be a good solution. The best way to find out if this is right for you or your child is to talk to your ear, nose, and throat (ENT) specialist.
Take-Home Message
- Tympanostomy is a very common and safe surgical procedure performed to treat problems such as frequent ear infections and fluid buildup in the ear.
- This removes fluid trapped in the ear, provides ventilation, and reduces the risk of future infections.
- This is a very short surgery, and you can go home from the hospital the same day.
- The tube usually falls out on its own between 9-18 months.
- Be sure to consult an ear, nose, and throat specialist to determine if this treatment is right for your child or you.
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