Why Does My Child Need Ear Tubes?
Myringotomy and insertion of ear tubes or myringotomy tubes, are used to treat and prevent chronic ear infections or fluid in the ear. Ear infections can occur when the Eustachian tube -- also called an auditory tube -- becomes filled with fluid instead of air, creating an environment for bacteria to grow and thrive.
Children are more likely to suffer from chronic ear infections because their Eustachian tube is at a more horizontal angle, shorter and narrower than that of an adult. A myringotomy is a small incision in the tympanic membrane to drain the pus and relieve pressure and ear tubes are tiny tubes made of plastic or metal which will hold the Eustachian tube open and allow fluid and bacteria to continue drainage and for ongoing ventilation of the middle ear. Without ear tubes, the myringotomy incisions would close up within a couple of days.
Indications For Ear Tubes
Insertion of ear tubes can help treat and prevent a variety of inner ear disorders. The most common reason for ear tube insertion is for treatment of acute/chronic ear infections, however, other reasons are:
- improve severe symptoms of ear infections
- hearing loss related to excess fluid in the middle ear
- damage to ear structures related to flying or scuba diving (barotrauma)
- speech and balance problems
How Are Ear Tubes Placed?
Ear tubes are usually placed in a same day surgery setting. This could be in a hospital or a surgical center. Before the surgery, someone will call you and give you instructions. Your child will not be allowed to eat or drink before surgery. This reduces the risk of aspiration of stomach contents into the lungs while under anesthesia.
The nurses and doctors will need a complete health history and a list of any medications that your child has been taking. Medications which may thin the blood, such as aspirin, should not be taken before surgery unless you are otherwise instructed by your physician. Even high doses of vitamin E and some other herbal supplements can thin your blood. If your child drinks from a bottle or special cup, make sure you bring it along. It's also a good idea to bring a "comfort item" such as a pacifier, blanket, or favorite stuffed animal.
The surgery itself is short, on average lasting half an hour or less. Your child will be sedated and should not have much, if any, pain. However, the combination of anesthetic drugs and the strange environment will probably make your child fussy.
You will need to remain at the hospital for a while after the procedure is over. Your child's temperature, blood pressure, heart and respiratory rates, and oxygenation will all be monitored while they recover from sedation.
What to Expect After Surgery
Before you leave the hospital, you will receive a comprehensive set of instructions explaining how to care for your child after surgery. It is important to follow these instructions carefully. Generally speaking, most children can return to normal activities a day or two later. However, it is very important that no water is allowed to enter the ear. Talk to your doctor about having your child fitted for ear plugs to be worn while swimming or bathing.
Will the Tubes Need to be Removed?
No. As your child grows, their Eustachian tube will grow as well. As the diameter of the tube increases the synthetic tube will become loose and fall out on its own. This is normal. The incision will heal on its own shortly after. Occasionally a new set of tubes will need to be placed, but often the growth of the Eustachian tube will be sufficient to prevent your child from suffering from chronic ear infections again. In some cases the ear tubes can become stuck in the auditory tube. In this case the surgeon may decide to remove the old ear tubes and place a new set in the ears at the same time.
American Academy of Otolaryngology - Head and Neck Surgery. Ear Tubes. Accessed: January 28, 2009 from http://www.entnet.org/HealthInformation/Ear-Tubes.cfm
Medical College of Wisconsin. Pediatric Otolaryngology: Myringotomy (Ear Tubes). Accessed: December 2, 2008 from http://www.mcw.edu/pediatricoto/CommonHealthProblems/MyringotomyEarTubes.htm