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®. The tubes are
placed to help drain the fluid out of the middle ear in order to reduce the
risk of ear infections. During an ear infection, fluid gathers in
the middle ear, which can affect your child's hearing. Sometimes, even
after the infection is gone, some fluid may remain in the ear. The tubes
help drain this fluid, and prevent it from building up.
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 drainage of fluids from
the ear.
Who
needs ear tubes?
The insertion of ear tubes may be recommended by your child's physician
and/or a 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
-
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
-
repeated ear infections that do not improve with antibiotics
over several months
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. (By the age of 5 years, the eustachian
tube becomes wider and longer, thus, allowing for better drainage of
fluids from the ears.)
-
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.
-
After
they come out, they may leave a small scar in the eardrum. This
may cause some hearing loss.
-
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.
-
surgeon
- a physician who specializes in the placement of the
tubes.
-
anesthesiologist
- a medical physician with specialized training in anesthesia. He/she
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 to drain the fluid and
relieve the pressure from the middle ear. 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 restored after the fluid is
drained. The tubes usually fall out on their own after six to 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 surgeon'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 one year later. Your child's physician will help manage the
care of your child in-between these visits, in agreement with the
surgeon.
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.
More Information
Schneider Children's
Hospital Division of Otolaryngology and Communication Disorders
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