Ear Tubes

Ear infections are usually painful, and are a common occurrence in childhood. Although, ear infections largely clear up on their own, if they are viral, or can be treated effectively with antibiotics, if bacterial, however, they can sometimes become a persistent problem, along with the build up of fluid in the middle ear, which in turn can lead to other problems like loss of hearing, speech problems, behavioral problems, and so on. When that’s the case, an ear, nose, and throat doctor, also referred to as an otolaryngologist, may be able to alleviate the problem by inserting an ear tube.

What Exactly is an Ear Tube?

As is apparent from the term, ear tubes are basically cylindrical shaped hollow tubes, which are also referred to as pressure equalization tubes, ventilation tubes, myringotomy tubes, or tympanostomy tubes. This is inserted into the tympanic membrane, or the eardrum, to enable air to get into the middle ear. Ear tubes are generally made of plastic, Teflon, or metal, and could be coated in order to lessen the chances of infection. Since ear tubes are inserted in the eardrum, they are not visible externally.

Ear tubes also are categorized into two types: one, short-term ear tubes, and second, long-term ear tubes. The tubes that are meant for short-term use are smaller in size and are meant to be kept in place for a period of six months, when they fall out by themselves. The ear tubes that are meant for long-term use larger in size, containing flanges, which help in securing them for a longer period of time. They usually have to be removed by the doctor, although they can also fall out by themselves.

Why is the Ear Tube Insertion Procedure Performed?

One of the usual reasons for this surgical procedure to be performed is the build up of fluid behind the eardrum, particularly in children, which persists for four months, or more, with accompanying loss of hearing or the chances of developmental problems occurring. Sometimes, if required, the procedure may also be carried out earlier than the four months.

Given below are some of the conditions ear tubes may be used for:

• Severe infections of the ear.
• For people affected by complications due to acute ear infection, like paralysis of the facial nerves, meningitis, brain infection, or mastoiditis.
• For people who undergo hyperbaric oxygen therapy.
• For people affected by barotraumas due to deep sea diving or flying.

Ear tubes alleviate the symptoms of ear infections because of the following reasons:

• They enable air to get into the middle ear.
• The accumulated fluid drains out into the ear canal from the middle ear through the ear tube.
• Thus, they help in clearing the fluid from the middle ear, therefore resulting in the restoration of hearing.
• They also help in preventing further fluid buildup in the middle ear, as long as they are in place.
• They help in decreasing the pressure in the ears caused by the fluid buildup, thus reducing the pain.

How is the Ear Tube Surgical Procedure Performed?

The ear tube insertion procedure, which is known as a myringotomy, is usually performed in an outpatient surgery clinic. Young children are usually administered a light general anesthetic, while older children or adults may forgo this if they are able to tolerate it without anesthetic. The myringotomy involves an incision made in eardrum with the help of a tiny scalpel or a laser, under a surgical microscope. Then the accumulated fluid is suctioned out. Next, the ear tube is inserted into this hole in order to ventilate the middle ear. In case the ear tube is not used, the surgical incision heals and closes in a few days, therefore the requirement for the insertion of the ear tube. Once the ear tube is in place, antibiotic eardrops are usually administered, which may be continued for the following few days. The whole procedure does not take more than 15 minutes, with the patient coming out of the anesthetic effect quickly.

In order to prevent bacteria form getting into the middle ear through the ear tube, it is recommended to use earplugs to keep the ears dry while bathing, or swimming, or any other activity involving water. The physician should be consulted about what ear protection measures should be undertaken after the surgery.

What are the Risks Involved in an Ear Tube Surgical Procedure?

Some of the complications that can occur are:

• Pus being discharged from the ear, known as otorrhea, which is a common problem and sometimes becomes persistent in a few children.
• The eardrum becoming thickened over time, which can lead to hearing problems.
• The blockage of the ear tube, resulting in the recurrence of ear fluid buildup and infections.
• The possibility of the ear tube slipping out and getting into the middle ear, which is rare.
• The occurrence of cholesteatoma, which is a tissue that forms in the middle ear, behind the eardrum. This is also rare.