Children's Health and Wellness

Tympanostomy Tubes

What are tympanostomy tubes?

Tympanostomy (ear) tubes are small tubes. They’re placed into your child’s eardrum by an ear, nose, and throat (ENT) surgeon. The tubes may be made of plastic, metal, or other material.

These tubes help to drain the fluid out of your child’s middle ear. This reduces his or her risk for ear infections.

During an ear infection, fluid builds up in your child’s middle ear. This can affect your child's hearing. Sometimes even after the infection is gone, fluid may stay in the ear. The tubes help drain this fluid. This keeps it from building up.

Children are most likely to get tubes between 1 to 3 years of age. By the age of 5 years, most children have wider and longer eustachian tubes. The eustachian tubes are canals that link the middle ear with the back of the nose. This lets fluid drain better from the ears.

Why might my child need ear tubes?

Your child’s healthcare provider may suggest tubes if your child has:

  • Fluid in both ears for 3 or more months and hearing problems
  • Fluid in one or both ears for 3 or more months and problems related to having fluid. These issues may include trouble with balance, ear pain, problems in school or with behavior, and frequent ear infections.

The benefits of ear tubes include:

  • Ear tubes may lower your child’s risk for ear infections.  
  • Your child’s hearing may get better.
  • Your child’s speech development won’t be affected.
  • The eustachian tubes can work better.
  • Children's behavior, sleep, and communication may be better if ear infections were causing problems.

What are the risks of ear tubes?

The following are some of the risks of tubes:

  • Some children with ear tubes still get ear infections.
  • Some children may get an infection from the tubes.
  • Sometimes the tubes leave a small hole in the eardrum after they come out. Your child may need surgery to fix this hole.

How long the tubes stay in can be a problem:

  • The tubes should fall out in about 1 year. If your child gets ear infections after the tubes fall out, the tubes may need to be replaced.
  • If the tubes stay in your child’s ear too long, a surgeon may need to take them out.
  • After the tubes come out, they may leave a small scar in the eardrum. This may cause some hearing loss.

How do I get my child ready for ear tubes?

You should talk about the risks and benefits of tubes with your child’s healthcare provider.

Getting ear tubes is normally an outpatient procedure. This means that your child will have surgery, and then go home that same day. Before the surgery, you'll meet with members of your child’s healthcare team. These people may include:

  • Nurses. Nurses help your child get ready for surgery. Operating room nurses help the surgeon during the procedure. Recovery room nurses care for your child as he or she recovers from general anesthesia.
  • Surgeon. This specialist places the tubes in your child’s ear.
  • Anesthesiologist or nurse anesthetist. This specialist gives sleep medicine (anesthesia) and watches your child during surgery.

Your child will get anesthesia. Your child may not be allowed to eat or drink after midnight the night before the surgery. Most children can have a normal dinner. Ask your child’s healthcare provider when he or she should stop eating and drinking.

What happens during ear tube insertion?

The surgery to place ear tubes in your child’s ear is called tympanostomy. It takes about 15 minutes. This procedure may include the following:

  • Your child will get general anesthesia. Your child’s healthcare team will watch him or her closely.
  • The surgeon will make a small opening in your child’s eardrum. This is done to drain the fluid and relieve the pressure from the middle ear. 
  • The surgeon places a small tube in the opening of the eardrum. This lets air flow into the middle ear. It also keeps fluid from building up.

What happens after an ear tube insertion?

Most children can go home 1 to 2 hours after surgery. Your child will need follow-up care from his or her surgeon. The ear tubes normally fall out on their own in about 6 months to a year.

You’ll get instructions on how to care for your child’s tubes. Your child may need to use ear drops. Your child may also need to wear ear plugs in the bath or when swimming.

Call your child's healthcare provider if your child has the following symptoms:

  • Drainage from the ear that lasts more than a few days after surgery or more drainage from the ears
  • Ear pain
  • Fever
  • Ear tube that falls out

Next steps

Before you agree to the test or the procedure for your child make sure you know:

  • The name of the test or procedure
  • The reason your child is having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • When and where your child is to have the test or procedure
  • Who will do the procedure and what that person’s qualifications are
  • What would happen if your child did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or your child has problems
  • How much will you have to pay for the test or procedure
Print Source: Up To Date. Overview of tympanostomy tube placement and medical care of children with tympanostomy tubes
Online Source: American Academy of Otolaryngologist Head and Neck Surgery. Tympanostomy Tubes in Children. Executive Summary (2013)http://oto.sagepub.com/content/149/1/8
Online Source: American Academy of Otolaryngology--Head and Neck Surgeryhttp://www.entnet.org/healthinformation/ear-tubes.cfm
Online Editor: Geller, Arlene
Online Medical Reviewer: Kacker, Ashutosh, MD
Online Medical Reviewer: Kolbus, Karin, RN, DNP, COHN-S
Date Last Reviewed: 12/1/2016
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