EAR TUBES
Joseph J. Donzelli, MD
(630) 420-2323
Most children will have at least one ear infection by the age of six months. If you or your
child has been advised to undergo placement of tubes, there is either fluid in the middle
ear space present for too long, or there has been too many individual ear infections over
the last year.
Tubes are a bypass for the ears natural drainage system call the Eustachian tube. The
Eustachian tube connects the middle ear cavity with the back of the nose, and in children
less than five years old, it is commonly shorter and more horizontal than in its mature
state. Recurrent ear infections often result in swelling of the Eustachian tube. Tubes that
are surgically placed in the eardrum take over the responsibility of the Eustachian tube
and, therefore, allow the Eustachian tube to relax and return to its normal functioning
state. This usually occurs by the time the tubes fall out, and, as such, most children,
approximately 80 percent, only need one set of tubes. Tubes last between six months and
one and a half years.
During this time, if the tubes are functioning, ear infections can occur but are easily
recognized because of copious drainage from the ear. Treatment in this situation is
usually antibiotic ear or eye drops used in the ear. An oral antibiotic is seldom needed
unless the patient has a sinus infection complicating the ear infection.
Routine care of ears with tubes is as follows: All ears, let alone ears with tubes, should
not be cleaned or probed with a Q-tip. As long as the tubes are functioning, earplugs
should be used when in water. This includes bath, shower, lake, and ocean water.
Chlorinated pool water is slightly different and requires the use of plugs only if the
patient is more than a surface swimmer (i.e. If he/she puts their head under, they should
use plugs). Plugs are available through my audiologist and can be purchased before or
after surgery. Children under the age of three typically get by with non-custom plugs.
Most children over three years old are becoming more aggressive swimmers and, as such,
should consider custom plugs fitted for the individual ear or a Bandit headband with the
non-custom plugs.
Routine follow up is usually one to two weeks after surgery and then every six months
until the tubes fall out and the eardrum seals back up again. If the patient should get an
ear infection during interim time, we usually treat with drops and reexamine seven to ten
days later to insure the tubes remain open and do not clog with mucus. On one of the
later visits, we may find one or both tubes stuck in the ear canal but out of the eardrum,
imbedded in wax. This would require removal in the office. Sometime the tubes
disappear, never to be seen again.
Surgery requires a general anesthetic. It is outpatient and takes approximately ten
minutes to complete. Surgery can be done with an active ear infection but is usually
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postponed if the patient has a bad cough or is wheezing. After surgery, children may be
crabby until all the anesthetic has worn off and they have eaten. The surgery is, however,
not painful. At most, a dose of Tylenol is needed. We often use eyes drops in the ears,
and typically, after surgery, drops are used between three and five days depending on
how the ears look at the time. If earplugs are not obtained before the operation, do not
worry. This is common and you can use a cotton ball and coat it with Vaseline to seal
and prevent water from entering the ear while in the bath prior to your first office visit.
Risks of surgery include anesthesia. As long as no one in the family has severe, life
threatening responses to anesthesia, it is unlikely that the patient would. Bleeding is
common, mixed with ear drainage for the first several days after surgery. Once the tubes
fall out, the eardrum may not completely heal in approximately three percent of patients.
If this occurs, continue ear water safety, and we usually continue checking the ear every
six months. If the ear fails to close, approximately one percent of children need to have
the eardrum surgically patched.
Tubes DO:
Make it easier on the ears in flight
Drain when infected
Typically reduce the number of infections
Typically fall out on their own but rarely require surgery to be removed
Last six to eighteen months
Occasionally get plugged by infectious material
Tubes DO NOT:
Always make children talk, walk or sleep through the night
Fall out because of aggressive physical activity
As always, if questions arise, please call (630) 420-2323 preferably during business
hours, but in case of emergency, there is always a physician available.
Joseph J. Donzelli, MD