Myringotomy (Ear Tubes)

Children that Could Use Ear Tubes                 Inserting Ear Tubes
Benefits & Risks of Ear Tubes                        Child's Care After Ear Tube Insertion

Myringotomy tubes are small tubes that are surgically placed into your child's eardrum by an ear, nose, and throat surgeon. The tubes are generally made of plastic or silicone. Tubes may be placed in your child's ears for several reasons. These include: 

• To reduce the chance of your child getting ear infections
• To help drain fluid from behind the eardrum that might be present after ear infections
• To help restore normal hearing to your child. Hearing is sometimes affected by the fluid from infections and tubes help prevent this hearing loss

About one million children each year have tubes placed in their ears. The most common ages are from 1 to 3 years old. By the age of 5 years, most children have wider and longer eustachian tubes (a canal that links the middle ear with the throat area), thus, allowing better ventilation and drainage of the ear. 

• Fluid in the ears for more than three or four months following an ear infection
• Repeated ear infections that do not improve with antibiotics over several months
• Fluid in the ears and more than three months of hearing loss
• Changes in the actual structure of the eardrum from ear infections 
• A delay in speaking

• Ear tubes help to reduce the risk of future ear infections.
• Hearing is restored in almost all children who experience hearing problems.
• Elimination of hearing loss will assist with speech and language development.
• Ear tubes allow time for the child to mature and for the eustachian tube to work more efficiently.
• Children's behavior, sleep, and communication may be improved if ear infections were causing problems. 

Risks:
(All of these problems are very rare.)

• Some children with ear tubes continue to develop ear infections.
• There may be problems with the tubes coming out.
• Tubes generally remain for about 12 months and in very rare cases may come out of the ear drum much sooner than this.
• If they remain in the ear too long, the surgeon may need to remove them.
• Some children may develop an infection after the tubes are inserted.
• Sometimes, after the tube comes out, a small hole may remain in the eardrum. This hole may need to be repaired with surgery. 

Inserting Ear Tubes

Myringotomy is the surgical procedure that is performed to insert ear tubes. Insertion of the tubes is usually an outpatient procedure. This means that your child will have surgery, and then go home that same day. 

Part of the unique aspect of the Pediatric Otolaryngology practice at the Medical College of Wisconsin is the team members who will assist your child with surgery. Our practice only utilizes pediatric nurses and pediatric anesthesiologists who have received specialized training to make sure that your child's surgery goes as smoothly as possible. 

Myringotomy involves making a small opening in the eardrum. A small tube is placed in the opening of the eardrum to ventilate the middle ear and to prevent fluid from accumulating. The child's hearing is generally restored after the fluid is drained. The tubes usually fall out on their own after about twelve months. 

Your child's recovery will be monitored closely. Your child must meet all discharge criteria in order to go home. 

Follow-up care is needed for your child based on the pediatric otolaryngologist's recommendations. Usually, you will return in about two weeks, then four to six months after the tubes have been inserted, and then approximately every four months until the tubes are out. Your child's physician will help manage the care of your child in-between these visits, in agreement with the pediatric otolaryngologist. 

Child's Care After Ear Tube Insertion

The following are some of the instructions that may be given to you following the placement of ear tubes in your child: 

• Your child's surgeon may order antibiotic ear drops to be placed after the initial insertion of the tubes, to prevent infection.
• You will be instructed to call your child's physician if your child experiences any of the following symptoms:  
                            - Drainage from the ear 
                            - Ear pain
                            - Fever 
                            - Myringotomy tube displaced (out of ear) 

You will be instructed on the use of earplugs while your child is in the water, based on the opinion of your child's pediatric otolaryngologist. Different physicians have different recommendations regarding the use of earplugs.