What is ear tube surgery, and what does it involve? When might a doctor recommend this surgery for your child, and what are the benefits and risks? Find out what to expect here.
Ear tube surgery (tympanostomy) is a procedure designed to help fluid drain out of the ears, and help stop middle ear infections. It's most commonly done in children 1 to 3 years of age, as toddlers are most prone to middle ear infections. In fact, it's one of the most common surgeries for toddlers. Here's what you can expect if your child needs ear tube surgery.
What is ear tube surgery (tympanostomy)?
Ear tube surgery, also called tympanostomy, is when doctors insert a tiny metal, Teflon, or plastic tube inside a child's eardrum. Once placed, the tube helps fluid drain out of a child's middle ear, reducing their risk of future middle ear infections (otitis media). It also helps even out the air pressure inside your child's middle ear, so it's the same as outside of the ear.
Why would a child need ear tube surgery?
Many children get middle ear infections (otitis media) when too much fluid builds up in their middle ear. Often, a cold, other respiratory virus, or allergies can cause this fluid buildup and lead to an infection. If there's too much pressure on the eardrum from the fluid, an ear infection could negatively affect a child’s hearing. And when this buildup lasts for long periods of time, and leads to lasting issues with hearing, this could negatively affect a child's speech development. Hearing loss from too many or too persistent ear infections could even become permanent.
Toddlers are especially prone to these infections because their eustachian tubes haven't widened and lengthened enough yet. (The eustachian tubes let fluid drain from the middle ear to the back of the nose, and help stop ear infections).
If a toddler (or any child) tends to get lots of ear infections, getting ear tubes can help the fluid drain out of their middle ear, and help stop future infections.
But not every toddler will need ear tube surgery. Doctors will usually only recommend ear tube surgery if a child:
- Gets many ear infections, especially ones that tend to be long-lasting
- Appears to have their hearing or speech negatively affected by ear infections
- Seems at risk for longer-term hearing, speech and/or learning problems from their repeated ear infections
- Had at least one ear infection that lasted 3 months or longer
Benefits and risks of ear tube surgery
Before your child receives ear tube surgery, it's important to know the main benefits and risks of the surgery.
- Ear tubes help reduce the risk of future ear infections, and the risk of pain that these infections can cause.
- Once the fluid in the ear is removed, hearing may be restored.
- Your child's speech and language development will no longer be impaired.
- Ear tubes buy your child time as the eustachian tube is still maturing – they do the job of the eustachian tube and help remove the fluid from the ears until the eustachian tube is ready.
- Your child may still get ear infections, or may get an infection as a result of the surgery.
- Ear tubes could scar the eardrum, which could cause some hearing loss.
- Your child might need another surgery if the hole in their eardrum (the one made during the surgery) does not heal.
- The tube could come out too early.
- The tube might stay in too long. If so, your child may need another surgery to remove it.
- The surgery could lead to bleeding.
What happens before ear tube surgery?
If a doctor recommends an ear tube surgery, they'll first check your little one's hearing and overall health. They'll also ask you about medicines your child is taking, any allergies your child has, and any other medical conditions your child has.
The doctor will tell you how to get your child ready for the surgery. Often, they'll tell you not to give your child any food or drinks starting at midnight the night before the surgery. That's because your little one usually needs to go into surgery on an empty stomach.
They might also ask you to stop giving certain medications to your child right before the surgery – and they'll let you know which ones are still ok to give your child on surgery day.
During the consultation, you can also ask the doctor any questions you have about the surgery, and address any concerns.
Before ear tube surgery, you might want to let your child know what's going to happen in simple terms: they'll go to the doctor, go to sleep, and have a tube put in their ear while they're sleeping.
What happens during ear tube surgery?
Ear tube surgeries usually take about 10-15 minutes, and happen in an operating room. They are done under general anesthesia, which means your child will be asleep the whole time.
Usually, the ear tube surgery will start with something called a myringotomy. This is when a surgeon makes a small hole in each eardrum. Then, the surgeon will remove any fluid that's still in the eardrum via the hole. They'll do this either by draining the eardrum or using suction. After that, the tympanostomy part happens – the surgeon will insert the ear tubes into your little one's ears.
Your child will stay in the hospital for a few hours, and they'll probably be sleepy for a bit. But they'll be able to go home the same day.
The hole made in your child's eardrum will heal on its own, without the need for stitches. And since the surgery all happened inside the ear, there won't be any visible cuts or marks.
Any hearing problems that the fluid caused will usually resolve once the ear tube is in place and the fluid is gone. The tube will help keep any more fluid from sitting in the middle ear.
Learn more about ear tube surgery from Children’s Hospital Colorado:
What happens after ear tube surgery?
Most children fully recover from ear tube surgery after 3 to 4 days.
Follow the surgeon's instructions to care for your child after the surgery. You may need to limit your child's running for a few days, and any playtimes where your child moves around, for a day or two. You might also need to put ear drops in your little one's ear, or use cotton balls to keep their ear dry.
If you see yellow fluid leaking out of your little one's ear, don't worry. This is normal, as long as it's within the first few days after surgery. Cotton balls may be used to absorb the fluid.
Vomiting once or twice after ear tube surgery is also normal, and so is nausea. It's usually best to reintroduce your little one to solid food in smaller amounts after surgery, rather than giving your child full meals right away.
Keeping your child's ears dry is crucial when they have ear tubes. So, your doctor may tell you to put earplugs in your child's ears when your child swims, takes a bath, or takes a shower.
The surgeon will schedule follow-up appointments to check on your child after ear tube surgery. But if you notice an abnormal smell coming from your child's ears, call the surgeon right away. That could be a sign of infection. You should also call the surgeon if your little one has ear pain or ear drainage after the first few days, develops a fever at any time, or has an ear tube fall out within the first few weeks.
Ear tubes usually fall out on their own as your child grows – there's no need for another surgery to remove the tubes. Usually, they'll fall out in a year or two. But if ear infections frequently occur after the first tubes fall out, your child might need ear tubes inserted again.
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