Question 1

What conditions can the ear tubes treat?

Accepted Answer

Middle ear infection, known as acute otitis media. Bacteria or viruses cause this infection. It causes inflammation and fluids in the middle ear. Ear tubes might help prevent new infections. Children who have three or more infections in six months or four or more infections in a year might be helped from ear tubes.Buildup of fluids without infection, also known as otitis media with effusion. One cause of this is fluid that stays in the ear after an infection. Other causes include problems with the eustachian tubes or another condition that keeps fluid from draining.Fluid buildup can cause hearing loss and balance problems. Ear tubes might help with hearing problems that cause a delay in speaking or other learning delays. These delays can cause problems in school.Ongoing middle ear infection, also known as chronic middle ear infection. This infection, which is caused by bacteria, doesn&#8217;t get better with antibiotics. An ear tube can drain the ear and make a way for antibiotic drops to be put right into the middle ear.Ongoing inflammation of the middle ear, also known as chronic suppurative otitis media. This inflammation causes a tear in the eardrum and continuing drainage from the ear. An infection, a blocked eustachian tube or injury to the ear can cause the tear. An ear tube can help the ear drain after surgery to fix the eardrum. The tube also makes a way for ear drops to be put right into the middle ear.

Question 2

What are the benefits?

Accepted Answer

Ear tubes can:Reduce the risk of future ear infections and the need for repeated courses of oral antibiotics. Even if your child develops an ear infection with tubes in place, many of these infections can be treated by putting antibiotic drops in the affected ear rather than having to resort to oral antibiotics.Improve hearing or correct hearing problems caused by the presence of either fluid or negative pressure.Improve speech development.Correct balance issues.Improve behavior, sleep and communication problems caused by chronic ear infections.Decrease the pain of an ear infection by eliminating the pressure (either positive or negative) that occurs during a middle ear infection or fluid build-up.

Question 3

What are the risks?

Accepted Answer

Ear tube placement is one of the most common childhood surgeries, with a low risk of serious complications. As with any surgery, there are still risks that need to be fully considered before deciding if ear tubes are the best option for your child.

Generally speaking, tubes remain in the eardrum (the tympanic membrane) and provide improved ventilation of the middle ear and do not require any further intervention other than routine follow-up in clinic. The first post-operative check usually occurs at six to eight weeks. Your child is then usually evaluated every six months until the tubes have extruded (been forced out) and the ear drums have healed.

Risks during and shortly after the operation include:

Typical risks of general anesthesia (i.e. allergic reaction, breathing or heart irregularities, or nausea and vomiting after surgery)
Bleeding, which can plug the tube’s opening
Infection
Fluid drainage

Tubes are not perfect and may cause a number of the following problems after they are placed:

They may fall out earlier than expected. This typically occurs when a child has an ear infection shortly after the tubes are placed.
They may become plugged with dried ear fluid, blood or debris, and they may need to be cleared or replaced.
They may fail to extrude from the ear drum and need to be surgically removed after two to three years.
They may fall out and leave a hole in the ear drum. This is typically the result of the ear drum being in poor condition and not having sufficient healing capacity to close the small incision site in the ear drum (the myringotomy site) after the tube has fallen out. Extremely thin drums or drums with a lot of scar tissue (known as myringosclerosis) have a harder time healing. If this occurs, your child’s doctor will wait to see if the perforation will spontaneously close. If it fails to close, another operation to repair the hole (paper patch, myringoplasty or tympanoplasty) is typically recommended.
Very rarely, a tube may fail to extrude and, instead, fall into the middle ear, despite having been properly seated in the ear drum for months. This is typically addressed surgically by making a small incision in the ear drum (myringotomy) and removing the tube from the middle ear.
After extrusion, the ear drum may be thinner at the tube site. Usually this does not cause any problems.
A common misconception is that tubes can cause scarring of the eardrum. The scarring of the drum (tympanosclerosis, myringosclerosis) is caused by the repeated exposure to inflammation (infections), not by the tubes themselves.

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