Tympanostomy with tube placement is the most common surgery performed on children in the United States. By the age of three, approximately one in 15 children will undergo tube placement for treatment of recurrent ear infections, persistent middle ear fluid, and eustachian tube dysfunction. The functioning pressure equalization tube, aka ventilation tube or tympanostomy tube, not only lowers the instance of ear infections but also allows the treatment of middle ear infection using antibiotic ear drops, delivering the needed medication directly to the middle ear. In majority of cases, topical antibiotic drops applied directly to the middle ear achieve a therapeutic concentration in the infected middle ear more effectively than the high dose systemic oral antibiotics commonly used for middle ear infections in children thus reducing the oral antibiotic use and likely saving the child from the unnecessary use of systemic oral antibiotics.
Ear Tube Surgery (Tympanostomy with tube placement)
The procedure to place ear tubes in children takes about 15-20 minutes and most of this time is dedicated to administration of anesthesia and arousing the child safely from anesthesia. Children go home the same day after their surgery. For adults, the ear tube is place in the office while awake with a topical anesthetic applied to the ear drum and takes about 5 minutes. The first dose of a prescription antibiotic ear drops is administered during the surgery. Your surgeon will discuss relevant findings and specific instructions for the post op period.
Ear tubes do not tend to be very painful. Most children will not even know they are there. If your child is in pain, use Tylenol® or Motrin®. Use the dosage recommended for your child's age and weight on the bottle. By the next day after surgery your child can return to all normal activities, a normal diet, and can go back to school or daycare.
Water precaution? How about swimming?
Most patients do not need to be overly concerned about water getting in the ears because the opening in the tube is very small. No special protection is needed for swimming on the surface of a pool or playing in the bathtub. Treated pool water (chlorinated pool) or sea/ocean water tend to have a lowner bacterial load than fresh water (rivers and lakes) and pose a minimal threat to middle ear infection. For children who go underwater more than 18 inches, you may consider trying some ear plugs to reduce the amount of water that enters the ear even when swimming in treated water.
What happens to the ear tube?
1. Ear tubes usually stay in the ear for 6-12 months. As the ear drum grows the tubes are gradually pushed out. Some tubes come out very quickly or may last for a few years. The residual hole in the ear drum usually closes within a few weeks to months after the tube falls out. Sometimes, the otolaryngologist (ENT) may have to remove the tubes.
2. A small number of children will have problems with the tubes including persistent tube infections, plugging of the tubes, tubes falling out early, and a persistent hole in the eardrum once the tube falls out.
3. There is a 25% chance your child will need more than one set of ear tubes. In those cases, an adenoidectomy may be recommended at the time of a second set of tubes.
4. Plan on making a follow up appointment about 4 weeks after surgery. The ear tube status should be monitored as long as the tubes remain in place.
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