Pediatric Tympanostomy Tubes
What are Tympanostomy Tubes (“Tubes”)?
Tympanostomy tubes are small plastic or silastic tubes that are inserted into the ear drum (tympanic membrane) to help ventilate the ear and prevent fluid from building up (OTITIS MEDIA WITH EFFUSION). In this way, tubes help prevent infections in the ear (OTITIS MEDIA). These tubes allow the pressure in the middle ear to be equal to the pressure outside the ear. This is why they are sometimes called PE tubes or “pressure equalization” tubes.
When are tubes a consideration?
Tympanostomy tubes may be suggested when your child’s ear infection has failed to improve with antibiotics or has fluid which will not clear after an appropriate length of time. Tubes are especially helpful in reversing the hearing loss due to fluid trapped behind the ear drum.
What is involved with Tympanostomy tube placement?
Placement of tubes occurs through the ear canal under a brief (five to ten minutes) general anesthetic, and rarely requires a blood test or IV. A tiny hole (myringotomy) is made in the eardrum, through which fluid is suctioned. Then a tiny tube (the pressure equalizing or PE tube) is placed in the hole allowing air to enter the middle ear. The procedure is painless and allows your child to resume normal activity upon leaving the hospital.
Tubes usually fall out of the ear (as the ear drum grows) within one to two years unless specified by your doctor.
- Do tubes cause scarring of the ear drum?The tubes selected for use in this practice are unlikely to cause changes in the ear drum. However, if ear drum scarring occurs due to tubes or repeated infection, this rarely causes hearing loss.
- Do the tubes ever fall in the ear instead of out?Very rarely, tubes migrate into the middle ear instead of out and into the ear canal. They can be easily retrieved under a brief anesthetic and the ear drum patched. In some instances, your physician may recommend leaving the tube alone.
- Can my child reach the tube?No, the ear drum (and tube) cannot be reached without a long narrow instrument.
- When the tube falls out, is there a hole left in the ear drum?The ear drum heals as the tube is pushed out. Very rarely, the ear drum does not heal completely, leaving a hole. This can be repaired by “patching” the ear drum, a common and highly successful procedure.
- Do tubes cause drainage?No. Once tubes are placed, the ear should not drain except in the first three days after surgery. If drainage occurs, this is usually the result of a cold, sinus infection, adenoid infection, or rarely, a mastoid infection.
- Will my child need a second set of tubes?Generally, no. About 20 percent of all children who get tympanostomy tubes in the first place need a second set. Risk factors include: infection starting before six months of age, adenoid disease, immune system problems, cleft palate and sinusitis.
- Are there any restrictions involved after the tubes are placed in my child?
We recommend your child wear ear plugs if ears are submerged in lake water. Most children do fine with any other water exposure. Should your child have a sensitivity in bath or pool water, your physician might recommend additional restrictions.
Thomas M. Andrews
Dr. Andrews specializes in the medical and surgical treatment of ear, nose and throat disorders of children and adolescents. His accreditations include Florida State Medical License and Ohio State Medical License. He is also a board member of the National Board of Medical Examiners and American Board of Otolaryngology, Head and Neck Surgery