Myringotomy and Tubes
You and your doctor have decided that your child needs myringotomy and tubes. The following information will help you to better understand what to expect.
Middle ear disease is perhaps the most common affliction of children. This is usually due to an immature eustachian tube, which is shorter and more horizontal than in an adult. The eustachian tube is a small tube that connects the middle ear cavity to the back of the throat. When the tube is working properly, it balances the air pressure. When this tube does not function correctly, a vacuum (negative pressure) forms in the middle ear. This vacuum is frequently associated with fluid or recurrent ear infections. Factors that can contribute to middle ear problems are:
- Frequent upper respiratory infections
- Day care
- Enlarged adenoid pad
Your doctor has recommended myringotomy and tubes to help bypass the eustachian tube problem and improve the air pressure.
Possible complications of tube insertion, as discussed by your physician, include:
- Usually a child will return to normal activity within 24 hours. Your child may react differently to noises, due to improved hearing.
- Ear popping and crackling noises with yawning, burping and chewing gum are common complaints after insertion of tubes.
- Discomfort, if present, is usually mild and may be relieved with Tylenol.
A slight straw-colored or blood-tinged discharge may occur for up to three days following surgery. Your child's physician will send home antibiotic ear drops to be given two drops, two times per day for two days (or as instructed). If drainage persists for longer than two days, please call your ENT physician. The physician may order an oral antibiotic if an infection is present at the time of surgery.
- Once the tube is in place, your child cannot feel it. Rough play will not dislodge the tubes.
- Tubes (short-acting) usually remain in place nine to12 months. At the discretion of the physician, placement of longer acting T-tubes may stay in place for over four years.
- A physician may need to remove the tubes if they stay in too long, i.e., two years, but normally the short-acting tubes work themselves out without discomfort.
- Your child may swim in clear or chlorinated water. Parents should realize, however, that this may increase the chance of infection. If an infection occurs, your physician may recommend ear plugs or no water activities.
- Try to not get soapy water in the ears when tubes are in place. Ear plugs or cotton may need to be used during bath time. Do not use "Silly Putty" as ear plugs. If ear plugs are needed, please let the staff know as we can give you a list of appropriate types of ear plugs.
- Your child should not swim in lake, pond, river, or ocean waters without plugs.
- If water has entered into the ear canal, you can wick the water out with tissue. You may need to start ear drops, if drainage is observed, and should continue using the drops for two to four days.
- Drainage may appear as a light yellow discharge or have a similar appearance as drainage from the nose.
- If drainage should occur without a fever, start the antibiotic ear drops as instructed (two drops, two times daily, for two days beyond when the drainage stops). Call the ENT office for further instructions if drainage persists beyond three to five days. If fever is present with the drainage, call the ENT office or see your primary care physician.
- Occasionally ear drops may burn. This is a common complaint and usually will stop burning after a few minutes. A small percentage of children, however, will have intolerable burning (crying longer than 15 minutes). If this should occur, stop the drops and call the ENT office for further instructions.
- No one should instill other drops such as Auralgan, Americaine or Debrox into the ear canal while tubes are in place.
- Children may fly in aircraft while tubes are in place. Children who play wind instruments may continue to do so.
- Do not clean the ear canal with a Q-tip. This could push ear wax farther into the canal and possibly plug the tube. Use a damp washcloth on the outer ear canal only.
- The initial post-op office visit is usually scheduled four to six weeks after surgery and may include a hearing test. Future appointments will be required on an individual basis.