Tympanostomy - Ear Tube Surgery

Ear tube insertion is the placement of tubes near a child’s eardrums. It is done to allow the fluid behind a child’s eardrums to drain so that the ears can function normally.

While the child is under general anesthesia (asleep and not able to feel pain), a small surgical cut is made in the eardrum. The built-up fluid is suctioned out through this cut. Then, a small tube is inserted through the eardrum. The tube allows air to flow in and fluid to constantly flow out of the middle ear.

Ear tube insertion may be recommended when fluid builds up behind your child's eardrum and does not go away after 4 months or longer. Fluid buildup may cause some hearing loss while it is present. But most children do not have long-term damage to their hearing or their ability to speak even when the fluid remains for many months.

An ear infection is another reason for inserting an ear tube. If an infection does not go away with the usual medical treatment, or if a child has many ear infections over a short period of time, the doctor may recommend ear tubes.

Ear tube insertion is also used sometimes for people of any age who have:

• Barotrauma (pressure injury) from flying or deep sea diving
  
• Hyperbaric oxygen therapy
  
• A complication from a severe ear infection, such as mastoiditis, brain infection, meningitis, or facial nerve paralysis

Your child’s ear specialist may ask for a complete medical history and physical exam of your child before the procedure is done.

Always tell your child’s doctor or nurse:

• What drugs your child is taking. Include drugs, herbs, and vitamins you bought without a prescription
  
• What allergies your child may have to any medicines, latex, tape, or skin cleaner

On the day of the surgery:

• Your child will usually be asked not to drink or eat anything after midnight the night before the surgery.
• Give your child a small sip of water with any drugs your doctor told you to give your child.
• Your child’s doctor or nurse will tell you when to arrive at the hospital.
• The doctor will make sure your child is healthy enough for surgery. This means your child has no signs of illness or infection. If your child is ill, the surgery may be delayed.
  

Children usually stay in the recovery room for a short time and leave the hospital the same day the ear tubes are inserted. Your child may be groggy and irritable for an hour or so as they awaken from anesthesia. Your child’s doctor may prescribe ear drops or antibiotics for a few days after the surgery.

Most children can return to normal activities the day after the surgery.

Some ear specialists will recommend earplugs or swimmer’s headbands while swimming or bathing to keep water out of the ears. If earplugs are not recommended for these activities, they may be recommended for diving in deep water. Check with your ear specialist.

The surgical cut heals on its own, without stitches. The hole closes, and the ear tubes usually fall out on their own after 14 months or so.

After this procedure, most parents report their children have fewer ear infections, recover fast from infections, and that they worry less about whether their child has ear infections.

If the tubes do not fall out on their own, an ear specialist may have to remove them. If ear infections return after the tubes fall out, another set of ear tubes can be inserted.

Tympanoplasty - Ear Drum Repair

Eardrum repair, called tympanoplasty, is a procedure to correct a tear in the eardrum (tympanic membrane). Ossiculoplasty is the repair of the small bones in the middle ear.

Using general anesthesia, an ear-nose-throat (ENT) specialist grafts a small patch from a vein or fascia (muscle sheath) onto the eardrum to repair the tear.

For problems with the small bones (ossicles), the surgeon will use an operating microscope to view and repair this chain of small bones using plastic artificial bones or ossicles from a donor.

A number of problems can permanently damage your eardrum (tympanic membrane) or harm the very small bones (ossicles) that are right behind the eardrum. These problems include chronic ear infections, trauma, cancer, and cholesteatoma.

This damage may cause hearing loss, pain, or an infection that does not go away.

If antibiotics or other treatments do not heal chronic ear infections, then surgical eardrum repair may be necessary.

Always tell your doctor or nurse:

• What allergies you may have to any medications, latex, tape, or skin cleanser
  
• What drugs you are taking, including herbs, herbs, and vitamins you bought without a prescription

On the day of the surgery:

• Take only a small sip of water with any drugs your doctor has prescribed
  
• Tell your doctor if you have signs of illness or infection
  
• You will usually be asked not to drink or eat anything after midnight the night before surgery
  
• Your doctor or nurse will tell you when to arrive at the hospital

Patients usually leave the hospital the same day as the surgery. It is important to avoid water in the ear. There are sometimes stitches behind the ear for the first week and packing material in the ear. Your health care provider may recommend the use of a hair cap when showering for a few weeks after the procedure.

In most cases, the operation relieves pain and infection symptoms completely. Hearing loss is minor. The outcome may not be as good if the bones in the middle ear need reconstruction along with the eardrum.