Ear Tubes for Adults: Everything You Need to Know

Ear tubes for adults are used to ventilate, equalize pressure, and or prevent the accumulation of fluid in the middle ear. Also known as grommets, ventilation tubes, or tympanostomy tubes, the devices are implanted in the eardrum (tympanic membrane) to treat severe or recurrent middle ear infections with hearing loss.

Ear tubes can also be used in adults with structural problems in the ear that cause the build-up of fluid and/or pressure. They may also be used to treat or prevent ear barotrauma (ear damage caused by extreme changes in atmospheric pressure).

Ear tubes, roughly 1/20th of an inch in length, are made of plastic or metal with large rims at either end. The shape holds them securely in place. Once implanted, the tubes cannot be seen.

This article explains when and why ear tubes are used in adults. It also describes what you can expect if you are scheduled to undergo the procedure.

Why Do Adults Get Ear Tubes?

Ear tubes are commonly used in children who are more likely than that adults to get middle ear infections (otitis media). Children are at greater risk because the horizontal position of the Eustachian tube (which connects the middle ear to the back of the throat) allows fluid and germs to accumulate in the middle ear rather than drain out.

In children, ear tubes are commonly used to treat middle ear infections with persistent fluid (serous otitis media), frequent middle ear infections, or ear infections that persist despite antibiotic treatment.

Ear tubes can be used in adults for these and other reasons, and are typically used after a first-line treatment has failed.

Other common indications for ear tubes in adults include:

• Eustachian tube dysfunction (EDT): This occurs when the lining of the Eustachian tube becomes swollen, narrow, or does not open and shut, allowing fluids to accumulate. Symptoms include pain, hearing loss, loss of balance, and ringing in the ears (tinnitus).
• Retracted eardrums: This is when the eardrum is sucked inward due to negative pressure in the middle ear. Causes in adults include chronic otitis media, chronic sinus infection, chronic respiratory allergies, or a prior ruptured eardrum.
• Prevention of barotrauma: People in need of hyperbaric oxygen therapy (such as those with gangrene or slow-healing wounds) are often given ear tubes to prevent ear damage caused by changes in atmospheric pressure.
• Treatment of barotrauma: Ear tubes may be used when a barotrauma injury is severe or other treatments have failed. Barotrauma can occur with activities like flying, sky diving, scuba diving, or driving in the mountains.

It is possible to have more than one of these conditions at the same time. For example, Eustachian tube dysfunction can often lead to middle ear infections, persistent fluid in the ears, or retracted eardrums.

What Is Ear Tube Placement Surgery?

The surgical placement of ear tubes is a relatively simple procedure. The first part of the procedure, called myringotomy, involves making a small hole in the eardrum with a scalpel or laser. The insertion of the tube is called tympanostomy.

In adults, the procedure can be done in a healthcare provider's office under local anesthesia. It typically takes around 15 minutes.

Several types of synthetic ear tubes exist, varying in their design and materials. The type of tube used will depend on your condition and how your ear canal and eardrum are shaped.

A Word From Verywell

Ear tube placement is usually a straightforward procedure that can be very effective for certain conditions in adults. It's important to follow up regularly with your surgeon to check the effectiveness of the tubes and detect any problems as soon as they occur.

— JANE KIM, MD, MEDICAL EXPERT BOARD

How Long Do Ear Tubes Stay In?

Short-term tympanostomy tubes, commonly used in children, last six to 18 months and typically fall out on their own. Long-term tubes used in adults are shaped like an H to stay in place longer.

Ear tubes usually fall out on their own within about two years. If they don't, your healthcare provider will take them out. Keeping a tube in too long can lead to a permanent hole in the eardrum and the need for surgical repair.

Possible Risks of Ear Tubes in Adults

While ear tube placement surgery is a safe and common procedure, some complications can arise, including:

• Scarring of the eardrum (tympanosclerosis)
• Tubes falling out of the ear or into the middle ear
• Tubes that are unable to be removed (retained tube)
• A hole in the eardrum that may not close after removal
• The thickening of tissues behind the eardrum (cholesteatoma)
• Continuous ear draining (otorrhea)

Ear tubes are typically temporary, although the procedure may need to be repeated depending on the condition. The longer a tube is kept in, the greater the risk of eardrum scarring or damage.

Contraindications

A myringotomy with tympanostomy may not be right for everyone. The procedure is contraindicated (avoided) in anyone with any sign of middle ear mass or blood vessel abnormality in or around the middle ear or Eustachian tube.

These include:

• Glomus tumor: This is a benign (non-cancerous) tumor that can sometimes develop in the middle ear as well as in the jugular vein and carotid artery of the neck.
• High-riding jugular bulb: This occurs when the junction of the jugular vein and blood vessels of the head are situated higher than normal.
• Displaced internal carotid artery: This happens when the major blood vessel delivering blood to the head shifts and end up curving toward to Eustachian tube and middle ear.

Having prior radiation therapy of the head or neck may also disqualify you from this procedure. 

How to Prepare for Ear Tube Surgery

Ear tube placement in adults is a quick and relatively uncomplicated procedure. Your healthcare provider will give you instructions to follow prior to the appointment.

Most people are safe to drive themselves after the procedure, but you may want to arrange for a ride just in case. Remember to bring your insurance paperwork and identification to the appointment.

What to Expect on the Day of Surgery

Ear tube placement is one of the most common procedures performed in the United States each year. Research suggests that 667,000 tympanostomy procedures are performed annually on children under 15 in the United States.

The surgery is performed by an ear, nose, and throat (ENT) specialist known as an otolaryngologist. It can be done in the provider's office under local anesthesia on one or both ears.

Before the Procedure

After arriving at the healthcare provider's office, you will be brought back to the procedure room and may be given a gown to change into or a waterproof drape to put over your clothes. Your healthcare provider will examine your ears and ask you to tilt your head so your ear is facing up and numbing drops will be placed in your ear.

During the Procedure

Once the drops have taken effect and your inner ears are numb, the healthcare provider will perform a myringotomy. This involves making a small hole in the eardrum with a scalpel or laser.

Once the incision is made, the healthcare provider may ask you to tilt your head so your ear is down to help the fluid drain. If there is a lot of fluid in the eardrum, your healthcare provider may use a small suctioning device to remove it.

Then the healthcare provider will use small forceps to gently guide the ear tube into place. If both ears require tubes, the procedure is repeated on the other side.

After the Procedure

Once the procedure is done, your healthcare provider may pack your ears with cotton to catch any additional drainage. If the procedure was performed due to hearing loss, your healthcare provider may perform an audiogram (a pure-tone hearing test) after the ears have drained to see if it helped.

You will be given instructions for aftercare and to schedule a follow-up visit in two to four weeks. Follow your healthcare provider's instructions and call the office if you have any questions or concerns as you recover.

Recovering From Ear Tube Surgery

You may experience continued drainage and some mild pain in the days following ear tube placement. Drainage can be thin, clear, yellow, or pink in color, and may contain blood. This is common in the first few days after the procedure and usually not cause for concern.

If drainage persists for several weeks, call your healthcare provider.

Recovery time for ear tube placement in adults is similar to that for children. While you will likely feel fine within a day or two of your procedure, you may need up to four weeks or less to fully heal without discomfort. Most people can return to school or work the day after having tubes placed.

Healing

Your healthcare provider may prescribe antibiotic ear drops which need to be taken for a few days after the procedure. Complete the full course of medication to avoid the development of antibiotic-resistant bacteria.

If you experience any pain or discomfort, over-the-counter pain relievers such as Tylenol (acetaminophen) or Advil (ibuprofen) should help. Over time, the eardrum will heal around the tube, helping to keep it in place.

Water Activities

Your healthcare provider will give you instructions regarding when it is safe to submerge your head underwater or get your ears wet. It is typically recommended to avoid getting water in your ears for the first week following the procedure.

According to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-NHS), it is safe to swim and bathe with ear tubes after the initial healing period.

Some ENT specialists recommend that you avoid getting water in the ear until months after the tubes have come out.

In the past, it was recommended to wear earplugs while swimming, showering, or bathing. Research shows no benefit to the practice. Because the tubes are so narrow, water does not appear to pose any concern. 

Summary

Ear tube surgery involves making a small cut in the eardrum and inserting a synthetic tube. An adult might need ear tubes placed to help treat certain conditions like fluid in the ear and auditory tube dysfunction. This is usually done only after first-line treatments have failed.

Ear tube placement is a simple procedure that should only take about 15 minutes. In adults, it's usually done under local anesthesia in an otolaryngologist's office. Most people can return to work the day after the procedure.

Ear tube placement surgery in adults is a quick procedure with a fast recovery time. However, the surgery is not always effective. Be sure to follow your healthcare provider's directions and schedule follow-up appointments. Most people need to be seen every six months to check on the tubes.