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Myringotomy (Ear tubes)

  • Myringotomy tubes (often called ear 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.

    Ear tubes come in a variety of sizes, shapes and materials that allow surgeons to best fit the tube to your child, but they're all designed to create an artificial hole in the eardrum to ventilate the middle ear.

    • 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.

    Once the decision is made, the General Pediatric Otolaryngology Program at Boston Children's Hospital oversees the surgery. Your child will be attended to by:

    • 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 performs the surgery.

    • Anesthesiologist. A pediatric medical physician with specialized training in anesthesia will perform a history and physical examination and formulate a plan of anesthesia for your child. Your child will need to undergo general anesthesia.

    Otolaryngology and Communication Enhancement

    Boston Children's Hospital
    300 Longwood Avenue
    Boston MA 02115


    617-355-6460


  • In-Depth

    What are the risks and benefits of ear tubes?

    The risks and benefits will be different for each child. It is important to weigh the pros and cons with your child's physician and surgeon.

    Benefits

    • 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 your 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.

    Risks

    • Some children with ear tubes continue to have ear infections.
    • There may be problems with the tubes coming out:
    • The tubes usually fall out on there own 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.
    • About 30 percent of children with tubes have to have tubes reinserted within five years.
    • After they come out, they may leave a small scar in the eardrum. This may cause some hearing loss.
    • 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.
  • Tests

    The insertion of ear tubes may be recommended by your child's physician and/or an ear, nose, and throat physician if your child has:

    • 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 her eardrum from ear infections
    • a delay in speaking
    • repeated ear infections that do not improve with antibiotics over several months

    Once placed, ear tubes are usually successful in significantly reducing ear infections—or eliminating them altogether. Most children will get one or two infections a year, and the infected pus typically drains on its own, thanks to the opening created by the tubes.

  • 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.

    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. Your child's hearing is restored after the fluid is drained. The tubes usually fall out on their own after six to twelve months.

    Fortunately, ear tubes require relatively little follow-up. Children who get them return to their otolaryngologist's office a month after the procedure, then every six months after that, and the tubes usually fall out on their own within nine to 12 months after placement. By that point, most children have outgrown their ear problems and don't require additional sets of tubes.

    How do I care for my child once her ear tubes have been placed?

    • Your child's surgeon may order antibiotic ear drops to be placed after the initial insertion of the tubes, to prevent infection.
    • You should 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 taught how to use 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.
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