Ear Infections

Ear tube placement

Surgery for middle ear infections often means placing a drainage tube into the eardrum of one or both ears. It's one of the most common childhood operations.

Reference Inserting ear tubes (myringotomy or tympanostomy with tube placement):

• May help to relieve hearing problems.
• Helps prevent buildup of pressure and fluid in the middle ear.
• Allows fluid to drain from the middle ear.
• Ventilates the middle ear after the fluid is gone.
• May prevent repeat ear infections.

While the child is under Reference general anesthesia Opens New Window, the surgeon cuts a small hole in the eardrum and inserts a small plastic tube in the opening.

Most tubes stay in place for about 6 to 12 months and then usually fall out on their own. After the tubes are out, the hole in the eardrum usually closes in 3 to 4 weeks. Some children need tubes put back in their ears because fluid behind the eardrum returns.

In rare cases, tubes may scar the eardrum and lead to permanent hearing loss.

Deciding about ear tubes

Doctors consider tube placement for children who have had repeat infections or fluid behind the eardrum in both ears for 3 to 4 months and have trouble hearing. Sometimes they consider tubes for a child who has fluid in only one ear but also has trouble hearing. Learn the pros and cons of this surgery. Before deciding, ask how the surgery can help or hurt your child and how much it will cost.

Opens New Window Ear Problems: Should My Child Be Treated for Fluid Buildup in the Middle Ear? Opens New Window

Care after ear tubes are placed

Ask your doctor about ear protection for your child. He or she can tell you when the hole in the eardrum has healed and when it's okay to go back to regular water activities.

You can use antibiotic eardrops for ear infections while tubes are in place. In some cases, antibiotic eardrops seem to work better than antibiotics by mouth when tubes are present.^{Reference 1}

Adenoids and/or tonsil removal

Adenoid removal (adenoidectomy) or adenoid and tonsil removal (adenotonsillectomy) may help some children who have repeat ear infections or fluid behind the eardrum. Children younger than 4 don't usually have their adenoids taken out unless they have severe nasal blockage.

As a treatment for chronic ear infections, experts recommend removing adenoids and tonsils only after tubes and antibiotics have failed. Removing adenoids may improve air and fluid flow in nasal passages. This may reduce the chance of fluid collecting in the middle ear, which can lead to infection. When used along with other treatments, removing adenoids (adenoidectomy) can help some children who have repeat ear infections. But taking out the tonsils with the adenoids (adenotonsillectomy) isn't very helpful.^{Reference 2} Tonsils are removed if they are frequently infected. Experts don't recommend tonsil removal alone as a treatment for ear infections.^{Reference 3}

Ruptured eardrum

Surgeons sometimes operate to close a ruptured eardrum that hasn't healed in 3 to 6 months, though this is rare. The eardrum usually heals on its own within a few weeks. If a child has had many ear infections, you may delay surgery until the child is 6 to 8 years old to allow time for eustachian tube function to improve. At this point, there is a better chance that surgery will work.

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