Tympanostomy Tubes for Children

What are ear tubes for children?

Ear tubes are small tubes that help to drain the fluid out of your child’s middle ear. This reduces the risk for ear infections. The tubes are placed into your child’s eardrum by an ear, nose, and throat surgeon. They may be made of plastic, metal, or other material.

During an ear infection, fluid builds up in your child’s middle ear. This can affect your child's hearing. Sometimes even after the infection is gone, fluid may stay in the ear. The tubes help drain this fluid. This keeps it from building up.

Children are most likely to get tubes between 1 and 3 years old. By age 5, most children have wider and longer eustachian tubes. The eustachian tubes are canals that link the middle ear with the back of the nose. This lets fluid drain better from the ears.

Why might my child need ear tubes?

Your child’s healthcare provider may suggest tubes if your child has:

• Fluid in both ears for 3 or more months and hearing problems

• Fluid in one or both ears for 3 or more months and problems related to having fluid. These issues may include trouble with balance, ear pain, problems in school or with behavior, and frequent ear infections.

The benefits of ear tubes include:

• Ear tubes may lower your child’s risk for ear infections.  

• Your child’s hearing may get better.

• Your child’s speech development won’t be affected.

• The eustachian tubes can work better.

• Children's behavior, sleep, and communication may be better if ear infections were causing problems.

What are the risks of ear tubes for a child?

The following are some of the risks of tubes:

• Some children with ear tubes still get ear infections.

• Some children may get an infection from the tubes.

• Sometimes the tubes leave a small hole in the eardrum after they come out. Your child may need surgery to fix this hole.

How long the tubes stay in can be a problem:

• The tubes should fall out on their own in about 1 year. If your child gets ear infections after the tubes fall out, the tubes may need to be replaced.

• If the tubes stay in your child’s ear too long, a surgeon may need to take them out.

• After the tubes come out, they may leave a small scar in the eardrum. This may cause some hearing loss.

How do I get my child ready for ear tubes?

You should talk about the risks and benefits of tubes with your child’s healthcare provider. Tell the surgeon about any medicines your child takes. This includes prescription medicines, over-the-counter medicines, vitamins, herbs, and other supplements.

In an age-appropriate way, tell your child what is going to happen. Use short and simple words to describe the procedure. Tell them why it's being done. Younger children tend to have a short attention span. So talk with them shortly before the surgery. Older children can have more time to understand the procedure in advance. Answer any questions your child may have in a concrete, clear manner. Stress the positive changes that will occur because of the tubes.

Getting ear tubes is normally an outpatient procedure. This means that your child will have surgery, and then go home that same day. Before the surgery, you'll meet with members of your child’s healthcare team. These people may include:

• Nurses. Nurses help your child get ready for surgery. Surgical nurses help the surgeon during the procedure. Recovery room nurses care for your child as they recover from general anesthesia.

• Surgeon. This specialist places the tubes in your child’s ear.

• Anesthesiologist or nurse anesthetist. This specialist gives sleep medicine (anesthesia) and watches your child during surgery.

Your child will get anesthesia. Follow any directions your child is given for not eating or drinking before the surgery.

What happens during ear tube insertion for a child?

The surgery to place ear tubes in your child’s ear is called tympanostomy. It takes about 15 minutes. This procedure may include the following:

• Your child will get general anesthesia. Your child’s healthcare team will watch them closely.

• The surgeon will make a small opening in your child’s eardrum. This is done to drain the fluid and relieve the pressure from the middle ear. 

• The surgeon places a small tube in the opening of the eardrum. This lets air flow into the middle ear. It also keeps fluid from building up.

What happens after an ear tube insertion for a child?

Most children can go home 1 to 2 hours after surgery. Your child will need follow-up care from their surgeon. The ear tubes normally fall out on their own in about 6 months to a year.

You’ll get instructions on how to care for your child’s tubes. Your child may need to use ear drops. Your child may also need to wear ear plugs in the bath or when swimming.

Call your child's healthcare provider if you have questions or if your child has any of the following symptoms:

• Drainage from the ear that lasts more than a few days after surgery or more drainage from the ears

• Ear pain

• Fever

• Ear tube that falls out earlier than expected

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 will you 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