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Ear Tubes – Who Needs Ear Tubes and Why?

An Apple a Day

Anil Gungor, MD – BreatheAmerica Shreveport

Painful and frequent ear infections are very common in children. Almost all children have had at least one episode by the age of five. The majority of ear infections are viral and resolve on their own. Few may require antibiotic treatment. If the infection becomes repetitive and/or fluid is retained in the middle ear, hearing loss and associated behavioral and speech problems may occur. In these cases, insertion of ear tubes is recommended.

Ear tubes are tiny grommets placed in the ear drum to allow air into the middle ear. Other names include tympanostomy tubes, myringotomy tubes, grommets, ventilation tubes, or PE (pressure equalization) tubes.

Ear tubes are made out of various materials. Short- term tubes are grommet-shaped and stay in place for six months to a year before falling out on their own. Long-term tubes are T-shaped and have large flanges to secure them in place. T-tubes also may fall out on their own, but are usually removed by the physician.

Ear tubes are recommended for children with repeated middle ear infections or who have hearing loss caused by the persistent presence of middle ear fluid. These conditions can lead to speech and balance problems, hearing loss, or changes in the structure of the ear drum.

Ear tube insertion is the most common childhood surgery performed with anesthesia. The average age for ear tube insertion is one to three years old. Inserting ear tubes may:

  • Reduce the risk of future ear infection.
  • Restore hearing loss caused by middle ear fluid.
  • Improve speech and balance problems.
  • Improve behavior and sleep problems caused by chronic and recurrent ear infections.

A general anesthetic is administered through a mask and ear tubes are inserted through a small cut in the ear drum. This is best done under a surgical microscope with a small scalpel through the ear canal.

The fluid behind the ear drum is suctioned out. The procedure usually lasts less than 15 minutes. Patients awaken quickly and are allowed to go home after about an hour of observation. Patients usually experience little or no postoperative pain, but grogginess, irritability, and/or nausea from the anesthesia can occur temporarily. Ear drops are administered for three days after the ear tube is placed.

Hearing loss caused by the persistent fluid is immediately resolved by surgery. An audiogram is performed a few weeks after surgery.

Tube insertion is a safe procedure with minimal complications. Complications may include the following:

  • When a tube comes out and the hole in the ear drum does not close, it can be patched through a surgical procedure called a tympanoplasty or myringoplasty.
  • Infections and repeated insertion of ear tubes can cause scarring. In most cases, this causes no problem with hearing.
  • Ear infections can still occur in the middle ear or around the ear tube. However, these infections are usually less frequent, result in less hearing loss, and are easier to treat, often with only ear drops. Sometimes an oral antibiotic is still needed.
  • Ear tubes can come out too early or stay in too long. If an ear tube expels from the ear drum too soon, fluid may return and repeat surgery may be needed. Ear tubes that remain too long may require removal by an otolaryngologist.