Frequently Asked Questions about Ear Tubes

Why do children get so many ear infections?

The eustachian tube which connects the throat to the middle ear is much shorter in children than in adults, causing fluids from head colds to drain more readily into the middle ear.

When is ear tube surgery indicated?

Hearing loss from middle ear fluid may affect speech, language, and learning during these crucial developmental years.  many doctors recommend placing these ventilating tubes (also known as PE tubes or pressure equalization tubes or myringotomy tubes or tympanostomy tubes) in the eardrum as they are the only reliable method of eliminating this hearing loss.  The benefits of reduced infections and improved hearing are felt by the majority of doctors outweigh the risks of surgery and anesthesia, which are low for this procedure.

Will ear tubes eliminate future ear infections?

Unfortunately, not always.  They do help reduce ear infections in most children.  Postoperative infections occur in about 10% of these cases.  Even when infections do occur, however, the tubes allow for drainage while the child is on eardrops and/or antibiotics to cure the problem.

Why does the procedure have to be done in the hospital?

Though the insertion of ear tubes is common and safe, it does require general anesthesia so the child can't move during the procedure.  It therefore requires a special setting.  Also, with general anesthesia there is a slight risk of aspiration.  Aspiration is when a child may vomit food or liquid that could be inhaled into the lungs.  A child's stomach must be empty before the surgery, which is why we ask taht your child has nothing to eat or drink after midnight, the night before the procedure. 

What can I do to help prepare my child?

Studies show that preparation reduces the stress felt by children.  Take a hospital tour.  Give honest, simple answers to your child's question.  Admit you don't know what you don't know and then find out.  Be prepared to repeat answers to questions as often as they are asked.  Try to be reassuring.  Tell a child that doctors and nurses are there to help.  If your child cries or expresses fear, let him or her know that it is okay.  Don't deny feelings.  By allowing feelings to be displayed, you are showing your child that you can be trusted to give continuing support.

Will tubes be placed in both ears?

The ear, nose, and throat doctor (ENT doctor) is a specialist and will make that determination.  Initially, 95% of all children receive tubes in both ears.  The ear tube is inserted in a microscopic incision after the surgeon suctions out any fluid from the middle ear.  The ear tube remains in the eardrum the same way a button stays place in a button hole.  Scarring the eardrum is seldom a problem as the incision almost always heals itself, but if necessary , even this can be corrected surgically.

Can I stay with my child during surgery?

Probably not.  Let the hospital's procedure be the guide.  Remember that your child will be asleep anyway.  The critical times are before the anesthesia is administered and just after your child awakens.  Most hospitals allow for parental contact during these times.

How long will the anesthesia last?

After your child is asleep, the surgical procedure takes only about 10 minutes.  Oxygen is sometimes given after the surgery to hasten your child's arousal.  Your child will probably not be asleep for more than half an hour altogether.

What kind of response can I expect when my child wakes up?

Occasionally, a child will wake up crying and upset, but that is not the norm.  The effects from anesthesia may range from none at all to some nausea or possible dizziness.  A delayed case of nausea may be triggered by the car ride home, so come prepared.

How long will the hospital stay be?

When you child is fully awake, you will be allowed to go home.  Sometimes the doctor will require that a child drink something or sue the bathroom before leaving.

Are there postoperative situations that I should know about?

Sometimes the doctor will prescribe eardrops to be used for a few days after surgery to deal with any remaining middle ear infection.  It is common to have some minimal ear drainage for 24-72 hours after the surgery.  It may be clear or slightly bloody.  If you have any suspicions that the recovery isn't progressing as it should or if your child develops a fever, call your physician. 

Are there any activities that my child should avoid?

Many doctors advise against swimming, diving, and water skiing.  Otherwise, your child can participate in all normal activities.  No over-the-counter or non-prescribe medications or objects such as a Q-tip should be put into the ear canal.  When bathing or washing, protect the ear with the earplugs that were provided to you (Doc's earplugs), or with a Vaseline impregnated piece of cotton.  You can also have a custom set of molded earplugs made in our office ($50-$55 per set).  Avoid ordinary earplugs; their design may damage the eardrum when the PE tubes are in place.  Do not use silly putty!  A swimming cap or a neoprene and velcro headband (known as an ear Band-it) can also be used.

Do we need to return to have the tubes removed?

A checkup with the doctor is routinely scheduled within 2-4 weeks after the procedure and periodically after that time.  The ear tubes will probably extrude on their own between 6-12 months post-op and the incision should heal on its own.  New designs in the ear tube itself prevent premature extrusion.  Because of their small size, parents do not usually notice when the ear tube falls out.  They may be in the external part of the ear canal for some time or obstructed in some ear wax.  For about 80% of children having ear tubes, the ear tube surgery is a one time occurrence.  Though there are others who may need the tubes replaced over the years, most children will outgrow the problem by the time they have reached puberty.