Tympanostomy: Pediatric Ear Tube Insertion Surgery

Fast Facts: Pediatric Ear Tube Insertion Surgery

• Ear tubes can alleviate serious issues with ear infections and drainage problems. 
• They can help with hearing loss, speech development, learning problems and balance issues. 
• The procedure typically lasts 5-10 minutes. 
• It’s one of the most common pediatric ENT surgeries. 

If your child has recurring ear infections, more than likely you’ve asked the question, “How do I make them stop?” For children with three or more ear infections over six months, often the answer is something called tympanostomy, more commonly referred to as ear tube insertion surgery.  

What are ear tubes?

Made of plastic or metal, ear tubes are cylinders placed in the ear drum that come in two types: short- and long-term tubes. Most fall out on their own, but some may require a removal procedure. 

• Short-term tubes are small and typically stay in the ear drum for six to 18 months.  
• Long-term tubes have a longer lifespan and can last for many years.  

You may also hear ear tubes called pressure equalization (PE) tubes, myringotomy tubes, ventilation tubes or tympanostomy tubes. 

Who may need ear tubes?

Young children, especially those between 6 months to 2 years old, are more likely to suffer from reoccurring ear infections. This is due to a still-developing immune system, smaller facial and nasal anatomy, and small and horizontal eustachian tubes that have a more difficult time draining fluid. Over time, fluid buildup can lead to issues, such as: 

• Hearing loss 
• Impaired speech development
• Learning issues
• Balance difficulties
• Discomfort due to pressure in the middle ear

Ear tubes can alleviate the pressure in the middle ear and prevent more serious ear infections by allowing the ear to drain more easily.  

Benefits of ear tubes may include: 

• Ear infections can be treated with drops instead of oral medication 
• Improved speech and balance 
• Lower chances of future ear infections 
• Prevent further hearing loss and restore hearing 
• And most importantly, an overall happier little one 

Children with certain conditions, such as Down syndrome or cleft palate, may be more likely to need ear tubes. 

What happens during the procedure?

Ear tube insertion surgery is performed with general anesthesia by a pediatric ear, nose and throat (ENT) surgeon and typically takes less than ten minutes. With the help of a microscope, a small incision is made to the ear drum where fluid behind the ear is removed. The ear tube is then placed in the opening, which helps to equalize pressure and prevent fluid buildup.

What should I expect after surgery?

Your child may experience these common short-term side effects after surgery: 

• Fussiness and tiredness the first day after surgery. 
• Itchy or plugged up ears that may last for a couple weeks. 
• Mild discomfort in the ear. 
• Small amounts of drainage with blood during the first week after surgery. 

Ear drops will be prescribed for your child’s ears to prevent infection or any potential blockages in the ear tubes. Depending on the cause, any hearing loss should immediately improve after surgery. Note that issues may not clear up right away in children with speech, language, learning or balance problems. 

An audiogram (hearing test) is often scheduled after surgery, especially if any hearing loss was discovered before the procedure. 

Are there bathing and swimming restrictions?

Some limitations may be in place for children when swimming or bathing. During bath time, avoid pouring water directly into their ears or fully submerging their head. Swimming restrictions may vary from treated versus untreated water, such as pool or lake water. Treated water carries less risk of ear infection. Your surgeon will specify any needed restrictions.

Are there side effects or complications?

Ear tube insertion surgery is a safe procedure with very few potential issues, but occasionally there are some, such as: 

• A hole in the ear drum (perforation) can occur around the ear tube if it doesn’t heal properly after surgery. This can be treated with a second procedure. 
• Ear infections can occur even after the tubes have been placed. These are usually mild and can be treated with antibiotic ear drops.   
• Ear tubes that stay in too long may require removal by an ENT surgeon. 
• Ear tubes that fall out too early may require a second surgery to place a new tube. 
• Scarring may occur where the tube was placed, but in most cases, this is harmless and poses no serious risks.

Talk to your child’s doctor if you’re interested in learning more about ear tube insertion.