Tympanostomy Tubes

Tympanostomy tubes are known by many names including ventilation tubes, myringotomy tubes, ear tubes, and pressure equalization (PE) tubes. Tympanostomy tubes are generally placed for recurrent ear infections despite medical treatment and/or persistent fluid behind the eardrums. Tympanostomy tubes are placed at any age, but are more common in children. It is estimated that between 500,000 to 1 million sets of ear tubes are placed annually in the U.S., and it remains one of the most common surgeries of childhood.


Understanding Tubes

The procedure can usually be done on an outpatient basis by a surgeon, who is usually an otolaryngologist (a surgeon who specializes in the ears, nose, and throat). In adults the procedure can often be done in the clinic setting by numbing the eardrum while the patient is awake. Occasionally in adults and normally in children the procedure is done in the operating room under general anesthesia. Children are usually given gas through a mask to go to sleep, and unless another procedure is being performed in addition to tubes, a breathing tube is usually avoided. The entire procedure is performed with the aid of a specialized microscope due to the small size of the tubes and eardrum. While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum (a myringotomy). The surgeon will then remove any fluid that is trapped behind the eardrum, and a small plastic tube is placed into the opening in the eardrum to keep it open. If no other procedures are being performed the child is then awakened from anesthesia. The entire procedure is very quick, usually lasting 15 minutes or less.

The tube ventilates the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment. If a child has enlarged or infected adenoids, the surgeon may recommend removal of the adenoids at the same time the ear tubes are inserted. Removal of the adenoids has been shown to reduce episodes of otitis media in some children, but not all. Research, however, has shown that removal of a child's tonsils does not reduce occurrences of otitis media. However, tonsilletomy and adenoidectomy may be appropriate along with tubes for reasons other than middle ear fluid.

Hearing should be fully restored once the fluid is removed. Some children may need to have the operation again if the ear infections or fluid returns after the tubes come out. The tubes normally stay in the eardrum for 6 to 12 months, after which time they usually come out spontaneously. They are so small that they are usually not seen when they fall out. Your doctor may want to see you back occasionally until the tubes do fall out. Occasionally, tubes stay in longer than expected. If tubes stay in for up to 3 years, your doctor may recommend that they be removed to reduce the risk of a permanent hole in the eardrum. Tubes can also fall out prematurely, and need to be replaced. Ask your doctor to explain any portion of the procedure you don�t understand.

Ear Tube Videos

For more information see the otitis media and tympanostomy tube post-op page.