Eustachian tube function is compromised by smoke exposure, viruses, allergies and large or infected adenoids. Children with special needs, syndromes, congenital malformations and speech delay may require early surgical intervention. Indications for surgery include recurrent acute ear infections (6 per year or 4 in 6 months), persistent middle ear fluid for 3 months or more, and ear drum retraction. If severe complications of otitis media such as meningitis, facial paralysis or febrile seizures occur, tubes are indicated.

The Surgery

Myringotomy and tubes is a very common surgical procedure performed under general (mask) anesthesia in children. In adults, it can often be done in our office while awake with topical anesthesia.

At surgery, a small incision is made in the drum and a ventilation tube is inserted through the hole after the middle ear fluid is removed with suction. Surgery takes 15 minutes and the recovery room stay is approximately 20 minutes. One parent is present during induction of anesthesia in the operating room.

Post-Op Care

Post-operatively, ear drops are used 4 times a day for 4 days to prevent the tube from becoming clogged and help resolve any infection. When drops are given, the patient should lie flat with the ear facing the ceiling. After drops are placed in the ear canal, the tragus (structure in front of the ear canal by the top of the jaw bone) should be pushed several times to pump the drops through the tube. Later, if yellow-green or bloody fluid drains through the tube then prescription ear drops are used (4 times a day for 4- 5 days). Only use drops approved by our office. If drainage persists, call our office during office hours.

The patient is seen 1 week after surgery. One month after this visit the patient is seen again and hearing is checked. After the one month post-op visit, the patient is examined every 3 months. Tubes last approximately 6-24 months and are often naturally extruded. If necessary, tubes can be removed in the office or O.R. depending on the patient's needs.
Complications of surgery are rare any may include ear drainage due to infection or a hole (perforation) in the ear drum after tube extrusion or removal. If it occurs, this hole is usually repaired with a patch in the O.R.

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