What is an ear tube insertion for children?

Eardrums are thin pieces of tissue deep in your child's ears. The space behind the eardrum is called the middle ear. It is connected to the back of the nose by a tube. This tube is called the eustachian tube. It allows air to fill this space and fluid to drain from the middle ear.

But sometimes these tubes don’t work well. This may be from allergies, infections, such as colds or enlarged adenoids. Adenoids are soft tissue behind the nose that helps your child fight infection. As a result, fluid can build up behind the eardrums. This can cause pain and hearing loss.

During ear tube insertion, your child’s healthcare provider places a tiny tube into the eardrum to let fluid leave the middle ear. It also lets air enter the middle ear through the eardrum. By the time these tubes come out, the body’s natural passageway from the middle ear to the back of the nose may be working better. But sometimes another tube will need to be placed.

These ear tubes are called tympanostomy tubes. They are small tubes made of plastic or metal. The healthcare provider may insert tubes that fall out on their own after 6 months to a year. Another kind is made to stay in place longer. The provider may need to remove that later.

Sometimes healthcare providers also remove the adenoids during the same surgery.

The most common ages for ear tube placement are from ages 1 to 3. By age 5, most children have wider and longer eustachian tubes. These let fluids drain more easily from the ear.

Why might my child need an ear tube insertion?

This procedure is very common in children. Your child may need an ear tube insertion if they: 

• Have had fluid in the ears for 3 or more months

• Have had a long-running ear infection

• Get ear infections often

• Have an abnormal shape to their ears or mouth

• Have had certain ear injuries

You should also know that:

• Ear tube insertion should not be done on kids who have had only 1 ear infection lasting less than 3 months

• If your child has repeated ear infections, they should be evaluated for speech, language, or learning problems .

What are the risks of an ear tube insertion for a child?

Possible risks of this procedure include:

• Problems from the anesthesia, such as breathing trouble or reaction to medicines

• Eardrum scarring

• Hearing loss

• Bleeding

• Infection

Some additional risks include:

• A hole in the eardrum that doesn’t heal after the tube comes out. This may need another procedure to fix it.

• The tube may come out too early. Or the tube may stay in place too long, needing the healthcare provider to remove it.

Your child may have other risks, depending on their specific health condition. Discuss any concerns with your child’s healthcare provider before the procedure.

How do I get my child ready for an ear tube insertion?

The healthcare provider will want to check your child’s overall health, ears, and hearing before the procedure. Before the procedure:

• You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.

• Discuss any medicines (prescription and over the counter) or supplements your child is taking. 

• Discuss your child’s allergies.

• Let the healthcare provider know if your child has ever had trouble with sleep medicine (anesthesia).

• Follow any directions your child is given for not eating or drinking before the procedure. Your child may not be able to eat or drink from midnight the night before the procedure.

• Discuss how long the tubes may stay in place and when your child will need follow-up appointments.

• You and your child will often need to arrive a few hours before the surgery.

What happens during an ear tube insertion for a child?

An ear, nose, and throat healthcare provider (ENT or otolaryngologist) often inserts ear tubes. It is often an outpatient procedure. The entire procedure often takes less than 15 minutes. The procedure may include:

• A specialist in giving medicine during surgery (anesthesia provider) will give your child sleep medicine and watch them during surgery. 

• The ear, nose, and throat healthcare provider will make a very small hole in the eardrum using a small knife (scalpel). 

• The provider will use a suction device to remove fluid from the middle ear through this hole. 

• The provider will place the tube into the hole. The hole will often heal on its own without stitches. 

An ear tube often falls out on its own in about 6 months to a year, unless it is a type that is meant to stay in longer.

What happens after an ear tube insertion for a child?

Your child will go to a recovery room to wake up. They may feel sleepy and irritable for 1or 2 hours after waking up from the anesthesia. Noises may seem especially loud for a while. In most cases, your child will be able to go home the same day.

The healthcare care provider may suggest that you give your child ear drops for a few days after the surgery. During this time, you may notice fluid coming out of the ear. Your child can go back to normal play the next day, and can start eating normal food as soon as they feel like it.

Your child may need to take care to keep water out of the ear while the tube is in place. You may need to put an earplug or cotton ball covered in petroleum jelly into the ear before your child swims or takes a bath. Ask the healthcare provider what they advise.

Be sure to keep any follow-up appointments so the provider can check on your child . Call the provider if you notice any of the following:

• Your child has a fever

• Your child has ear pain

• Drainage from the ear smells bad, is thick, or has a yellow or green color

• The ear tube falls out

• Your child has problems hearing

Next steps

Before you agree to the test or procedure for your child make sure you know:

• The name of the test or procedure

• The reason your child is having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• When and where your child is to have the test or procedure

• Who will do the procedure and what that person’s qualifications are

• What would happen if your child did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or your child has problems

• How much you will have to pay for the test or procedure