Kid’s Ear Tube Surgery: Procedure & Recovery

What Are Ear Tubes?

Ear tubes (myringotomy tubes) are small tubes that are surgically placed into your child’s eardrum to help drain the fluid out of the middle ear in order to reduce the risk of ear infections.

When Does a Child Need Ear Tubes?

Your child’s doctor may recommend ear tubes if one or more 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 antibiotics over several months

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, allowing for better drainage of fluids from the ears. The tubes usually fall out on their own after six to twelve months. After they fall out, if ear infections recur, they may require replacement.

Ear Tubes in Kids: Before Surgery

Insertion of the tubes is typically an outpatient procedure. This means that your child will have surgery, and then go home that same day. We know the experience of your child undergoing surgery can be stressful. Our certified child life specialists help lower anxiety by introducing patients and their families to the hospital environment, procedures and equipment. Through therapeutic medical play and age-appropriate surgery preparation, they help kids feel comfortable – even escorting them to the operating room.

Ear Tubes in Kids: After Surgery Recovery

Ear Tube Pain and Drainage

Your child’s ear may be slightly sore for the first several hours. If your child has pain, you may give the recommended dosage of acetaminophen (Children’s Tylenol). Your child may have a small amount of blood-tinged drainage from the ear for 1-2 days after the operation. If the drainage persists, there could be an infection. Your primary care physician can successfully treat these infections. Usually antibiotic ear drops are sufficient for treatment. Severe infections may require oral antibiotics. If drainage persists despite medical therapy, please call our office to make an appointment.

Diet and Activity

Immediately after surgery, your child will do best with a liquid diet. When your child is up and acting normally, a regular diet may resume. On the day after surgery, your child may return to normal activity, including school or daycare.

Ear Drops For Ear Tubes

Ear drops are often prescribed after surgery. Begin using these drops on the evening of surgery, as directed by your doctor. Prior to using drops, warm the bottle by either carrying it in your pocket or holding in your hand for a few minutes. After instilling the drops, massage the front of the ear next to the opening of the ear canal several times. This helps to propel the drops into the ear canal and through the tube. Your doctor may recommend additional use of drops if there is drainage for more than 72 hours after surgery since persistent drainage is a sign of ongoing infection. If the drainage continues for more than seven days, or if other symptoms arise, please call our office.

Bath After Ear Tubes

Do your best to prevent bath water from filling your child’s ear canals. The ears should not be completely submerged in water. However, water splashing on the outer ear should not cause a problem. If your child likes to place his or her head completely under water in the bath, keep the water at a very low level. During hair washing, some children will wear an inflatable visor designed to keep water off of their face. Other parents simply hold the child’s ear down and cup their hand over the ear as they rinse the hair.

Swimming With Ear Tubes

You may be wondering if your child can swim after getting ear tubes – yes, but with certain precautions. Though surface-level swimming is not known to cause more ear infections, we recommend using ear plugs while swimming. Additional protection can be provided by using a swim cap over the ear plugs. The top of a racing cap can be removed so the child is wearing a sporty band over the ears instead of a full cap. If water does enter the ears, do not panic. In most instances, nothing bad will happen. If any drainage is observed, please contact your pediatrician to initiate treatment with antibiotic ear drops. The drops will address the infection and will mechanically keep the tube from getting plugged by the dried pus. Remember: Children wearing ear plugs will not be able to hear as well.

Kid’s Ear Protection

Types of ear protection include:

• A cotton ball lightly coated with Vaseline
• Silicone putty-type ear plugs
• Other types of waterproof ear plugs (eg. Doc Proplugs)
• Ear Band-It or custom-made ear plugs. If water does get in your child’s ears, simply tip their head to each side. There is a good chance that the water has not gone through the tiny opening in the tube. However, if you do observe drainage over the next few days, an infection has most likely developed.

Other Precautions

Children with ear tubes or perforation of the ear drum should not have the following put in their ear canals:

• Topical pain medications (such as Auralgan)
• Wax removal preparations (such as Debrox, Ceruminex)
• “Swimmer’s ear” preparations
• Home remedies such as oil, peroxide, vinegar and alcohol

Follow-up After Ear Tubes Surgery

Your child should be seen for a follow-up appointment in our office 2-3 weeks after surgery. If this has not already been arranged, please call the office to schedule this appointment. If your child needs a hearing test, please request that it be scheduled during the same visit. After this appointment, your child can be followed by their primary care physician. You should return for follow-up evaluation by your ENT specialist every six months.

My child has recurring ear infections. Will they need ear tubes?

During an ear infection, fluid builds up behind the eardrum in a place called the middle ear space. Normally, when the ear infection has run its course, the fluid drains out of the middle ear into the back of the nose through the body’s natural drainage tube called the Eustachian tube.

Sometimes this fluid doesn’t go away because the Eustachian tube remains swollen and can’t open. Fluid trapped behind the eardrum causes hearing loss because it prevents the eardrum and hearing bones from vibrating normally.

Ear tubes are small tubes placed into the eardrum to help ventilate the middle ear and prevent recurrent ear infections. They are the size of a pen tip and are typically made of

• Silicone
• Fluoroplastic
• Titanium

When does my child need ear tube surgery?

Tubes are placed when a child has recurrent or chronic ear infections (otitis media). Tubes are generally recommended when a child has three infections in six months; four infections in one year; or persistent ear fluid lasting three months or more with associated hearing loss. Your ENT specialist can help determine if ear tubes are needed.

What is the procedure for tubes in ears?

Ear tubes are put in by an ear, nose and throat surgeon. A small incision is made in the eardrum and the tube is then placed through this hole. The procedure requires a child to hold perfectly still. Since children cannot hold still for this procedure it is performed in the operating room under general anesthesia.