One of the most common surgical procedures in children is the placement of tubes within the eardrum, also known as tympanostomy tubes. Common reasons for initial tube placement include recurrent, acute ear infections or persistent middle-ear fluid which fails to clear over time.
With time the structure we call the Eustachian tube, which naturally drains the middle ear space to the back of the nose, improves its ability to function and it is possible a child may not need the ear tubes anymore. Ear tubes most often fall out on their own. When the ear tubes have not fallen out over time, a decision should be made as to whether the child has ”outgrown” the underlying issue.
While ear tubes will most commonly fall out on their own over time, sometimes the tube(s) fail to fall out. If they have not fallen out by three years post-placement, we start to consider if a child may be a candidate to have them removed. For example, if the child is no longer having ear infections or ear drainage.
There other instances where tubes that have been in place for a prolonged period of time are removed due to chronic infections that fail to clear with topical medications.
There are several different materials and styles of tubes available for use. Some ear tubes are soft and flexible, and in some patients can be safely removed in an office setting using a microscope and fine instruments to gently slide them out. Other types of tubes are more rigid and would need to be removed under a brief inhalational anesthestic.
If tubes are left in place for longer periods of time, there can be a slightly greater risk the small hole or what we call a perforation in the eardrum does not heal, and an eardrum patch repair procedure may be needed.
After placement, it is important to follow-up with your ENT surgeon for routine office visits at least every six months, and in-between, as needed, with any ear concerns.
For more information on Nationwide Children’s Hospital’s Ear, Nose and Throat services, click here.
Kris R. Jatana, MD, FAAP, a native of Columbus, has joined the Department of Pediatric Otolaryngology at Nationwide Children’s Hospital and is currently an assistant professor in the Department of Otolaryngology - Head and Neck Surgery at The Ohio State University.
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