Ear Tube Surgery for Children
Painful ear infections occur in children-by the age of five. Nearly every child has experienced at least one episode. Most ear infections either resolve on their own (viral) or are effectively treated by antibiotics (bacterial). But sometimes, ear infections and/or fluid in the middle ear may become a chronic problem leading to other issues such as hearing loss, behavior, and speech problems. In these cases, insertion of an ear tube by an otolaryngologist (ear, nose, and throat specialist) may be considered.
Ear tubes are tiny cylinders placed through the ear drum (tympanic membrane) to allow air into the middle ear. They also may be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. These tubes can be made out of plastic, metal, or Teflon and may have a coating intended to reduce the possibility of infection. There are two basic types of ear tubes: short-term and long-term. Short- term tubes are smaller and typically stay in place for six months to a year before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist is often necessary.
Ear tubes are often recommended when a person experiences repeated middle ear infection (acute otitis media) or has hearing loss caused by the persistent presence of middle ear fluid (otitis media with effusion). These conditions most commonly occur in children, but can also be present in teens and adults and can lead to speech and balance problems, hearing loss, or changes in the structure of the ear drum.
Ear tubes are inserted through an outpatient surgical procedure under light sedation anesthesia called a myringotomy procedure. A myringotomy refers to an incision (a hole) in the ear drum or tympanic membrane. This is most often done under a surgical microscope with a small scalpel (tiny knife), but it can also be accomplished with a laser. Once the hole is made, the fluid behind the eardrum is suctioned out leaving a clear middle ear space. The tube is inserted in the hole. If an ear tube is not inserted, the hole would heal and close within a few days. To prevent this, an ear tube is placed in the hole to keep it open and allow air to reach the middle ear space (ventilation).
After surgery, children should hear immediately better. The tubes will remain in the eardrum from 6 months to a year. At that point the natural growth of the eardrum will push the tube out and the hole that it was in will close naturally. The tubes are so tiny you probably will not even see them fall out.
Possible complications Although rare, some complications can occur such as persistent perforation after the tube has fallen out, persistent tube placement needing manual removal, scarring and infection.