Ear infections are very common amongst children. When a child has recurrent ear infections or persistent fluid build-up in the ears that cause hearing problems or speech delays, a doctor may recommend a Myringotomy.
What is a Myringotomy?
A Myringotomy is a procedure that involves placing tubes through the eardrums to equalize the pressure. A small incision is made in the eardrum and any fluid in the ear is removed. In nearly all situations, a tiny plastic tube is inserted into the eardrum to keep the middle ear exposed to oxygen for an extended period of time. These ventilating tubes stay in place for six months to several years. In time, they will move out of the eardrum and fall into the ear canal. Your doctor may take out the tube during a routine office visit or it may simply fall out of the ear on its own.
Why is the procedure performed?
Ear tube insertion may be done when fluid builds up behind your child’s eardrum and:
- Does not go away after 3 months and both ears are affected
- Does not go away after 6 months and fluid is only in one ear
If an infection does not go away with treatment, or if a child has numerous ear infections over a short period of time, the doctor may recommend ear tubes.
Ear tubes are also used for people of any age who have the following symptoms:
- A severe ear infection that spreads to nearby bones or the brain, or that damages nerves
- Pressure injury to the ear from flying or deep sea diving
Description of procedure
In the operating room, your child will be asleep and under general anesthesia. The procedure typically only takes 10-15 minutes. After the anesthetic takes affect, the surgeon will make a small surgical cut in the eardrum. Any fluid that has collected behind the eardrum will be removed with suction through this cut. A small tube is then placed through the eardrum. The tube allows air to flow in so that pressure is the same on both sides of the eardrum. Also, trapped fluid can flow out of the middle ear, which prevents hearing loss and reduces the risk of ear infections.
Before the procedure
Your child’s ear doctor may ask for a medical history and physical exam of your child before the surgery is done. A hearing test is also recommended before the procedure is performed.
Prior to the procedure
Make sure to communicate to your child’s doctor or nurse what drugs your child is currently taking. Also include any drugs, herbs, or vitamins you may have bought without a prescription.
List any allergies your child may have to any medications, latex, tape, or skin cleaner
On the day of the surgery
- Your child will often be asked not to drink or eat anything after midnight the night before the surgery; this includes water or chewing gum. Anything in the stomach can increase the likelihood of an anesthetic complication.
- Your child’s doctor or nursery will tell you when to arrive at the hospital.
The doctor will make sure your child is healthy enough for surgery. If your child is ill or has a fever, the surgery may be delayed. However, still go to the surgical facility as planned. Your doctor will decide if it is safe to proceed with the surgery.
After the procedure
Children are taken to a recovery room for a short period of time after the surgery to be monitored by a nurse. He or she should be able to leave the hospital the same day as the ear tubes are inserted. Your child may be groggy and fussy for an hour or so while waking up from anesthesia. Your child’s doctor may prescribe eardrops or antibiotics for a few days after the surgery. Most kids can return to normal activities the day after the surgery. Some ear doctors may recommend using earplugs or swimmer’s headbands while swimming or bathing to keep water out of the ears. If earplugs are not recommended for these activities, they may be suggested for diving in deep water. Make sure to check with your health care provider.
The surgical cut will heal without stitches. Once the incision has closed, the ear tubes will fall out after 14 months or so on their own. If the tubes do not fall out on their own in a few years, an ear specialist may have to remove them. If ear infections return after the tubes fall out, another set of ear tubes can be inserted.
After this procedure, most parents report that their children have fewer ear infections and recover more quickly from infections.
Risks and Complications
Despite ear tube surgery being extremely common, minor complications are still possible. These include:
- Failure to resolve ear infections
- Chronic ear drainage
- Need for further and more aggressive surgery such as tonsils, adenoid, sinus, or ear surgery
- Hearing loss
- Scarring of the eardrum
- Thickening of the eardrum over time, which affects hearing in a small percentage of patients
- Small hole in the eardrum that does not heal after the tube falls out
Ear Tube Surgery (Myringotomy)