Myringotomy Tubes

What are myringotomy tubes (also called ear tubes, tympanostomy tubes, or ventilation tubes)?
Myringotomy tubes are small tubes that are surgically placed into your child's eardrum by an ear, nose and throat surgeon. The tubes may be made of plastic, metal or Teflon®. Tubes may be placed in your child's ears for several reasons. These include:

  1. To reduce the chance of your child getting ear infections.
  2. To help drain fluid from behind the eardrum that might be present after ear infections.
  3. To help restore normal hearing to your child. Hearing is sometimes affected by the fluid from infections and tubes help prevent this hearing loss.
About one million children each year have tubes placed in their ears. The most common ages are from 1 to 3 years old. By the age of 5 years, most children have wider and longer eustachian tubes (a canal that links the middle ear with the throat area), thus, allowing better ventilation and drainage of the ear.



Who needs ear tubes?
The insertion of ear tubes may be recommended by your child's physician and/or an ear, nose and throat physician if several of the following conditions are present:
  • Fluid in the ears for more than three or four months following an ear infection.
  • Repeated ear infections that do not improve with antibiotics over several months.
  • Fluid in the ears and more than three months of hearing loss.
  • Changes in the actual structure of the eardrum from ear infections.
  • A delay in speaking.

What are the risks and benefits of ear tubes?
The risks and benefits will be different for each child. It is important to discuss this with your child's physician and surgeon.
The following are some of the possible benefits that may be discussed:
  • Ear tubes help to reduce the risk of future ear infections.
  • Hearing is restored in some children who experience hearing problems.
  • Speech development is not harmed.
  • Ear tubes allow time for the child to mature and for the eustachian tube to work more efficiently.
  • Children's behavior, sleep and communication may be improved if ear infections were causing problems.
The following are some of the risks that may be discussed:
  • Some children with ear tubes continue to develop ear infections.
  • There may be problems with the tubes coming out:
    • The tubes usually fall out in about one year. After they fall out, if ear infections recur, they may need to be replaced.
    • If they remain in the ear too long, the surgeon may need to remove them.
  • About 30 percent of children with tubes have to have tubes reinserted within five years.
  • Some children may develop an infection after the tubes are inserted.
  • Sometimes, after the tube comes out, a small hole may remain in the eardrum. This hole may need to be repaired with surgery.

How are ear tubes inserted?
Myringotomy is the surgical procedure that is performed to insert ear tubes. Insertion of the tubes is usually an outpatient procedure. This means that your child will have surgery and then go home that same day. Before the surgery, you will meet with different members of the healthcare team who will be involved in your child's care. These may include:
  • Nurses - day surgery nurses prepare your child for surgery. Operating room nurses assist the physicians during surgery. Recovery room (also called the Post-Anesthesia Care Unit) nurses care for your child as he/she emerges from general anesthesia.
  • Otolaryngologist - a surgeon who specializes in the placement of the tubes. Also called "ENT."
  • Anesthesiologist - a medical physician with specialized training in anesthesia. The doctor will perform a history and physical examination and formulate a plan of anesthesia for your child. The plan will be discussed with you and your questions will be answered. Insertion of myringotomy tubes requires general anesthesia in children.
Myringotomy involves making a small opening in the eardrum. A small tube is placed in the opening of the eardrum to ventilate the middle ear and to prevent fluid from accumulating. The child's hearing is generally restored after the fluid is drained. The tubes usually fall out on their own after about twelve months.

Your child's recovery will be monitored closely. Your child must meet all discharge criteria in order to go home.

Follow-up care is needed for your child based on the ENT or otolaryngologist's recommendations. Usually, you will return in about two to four weeks, then four to six months after the tubes have been inserted and then approximately every four months until the tubes are out. Your child's physician will help manage the care of your child in-between these visits, in agreement with the otolaryngologist or ENT.


Care of the child after the ear tubes are inserted:
The following are some of the instructions that may be given to you following the placement of ear tubes in your child:
  • Your child's surgeon may order antibiotic ear drops to be placed after the initial insertion of the tubes, to prevent infection.
  • You will be instructed to call your child's physician if your child experiences any of the following symptoms:
    • Drainage from the ear.
    • Ear pain.
    • Fever.
    • Myringotomy tube displaced (out of ear).
  • You will be instructed on the use of earplugs while your child is in the water, based on the opinion of your child's physician. Different physicians have different recommendations regarding the use of earplugs.
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