Alternative Names ear tube surgery, myringotomy, tympanostomy, grommet insertion
Definition Ear tube insertion is a surgical procedure used to drain fluid from the middle ear. In this procedure, a small cut is made in the eardrum. Next, special tubes, called Grommets, are placed in the ear to allow fluid to drain from the middle ear. These tubes also allow air to circulate through the area behind the middle ear.
Usually the eustachian tubes, which connect the back of the throat behind the nose to the middle ear, allow air to get into the space behind the eardrum. Air is needed in this space to allow the eardrum to move and function correctly. When air is not present in this space, fluid can build up and bacteria can grow. This can cause ear infections. Inserting Grommets gives the eustachian tubes time to grow and begin to function better.
Most ear tubes fall out on their own with 3 to 18 months of the procedure. The most common time is between 6 and 9 months. A doctor will usually re-examine the ear periodically to see if the tubes are still in place and working well or to see if they have fallen out. A person may not always see the tube if it falls out.
Who is a candidate for the procedure? Ear tube insertion may be recommended for people, especially children, who have:
eustachian tubes that are immature or have not formed correctly while a child is young
recurrent ear infections, called chronic otitis media, despite the use of antibiotics
persistent, severe ear pain unrelieved with analgesics
hearing loss due to fluid in the eardrum, which can cause problems with speech development
complications from ear infections, including inflammation or infection of other parts of the ear and jaw
How is the procedure performed? Usually a person is given a general anaesthesia to temporarily put him or her to sleep. Next, a small cut is made in the eardrum, and any fluid is suctioned out. The surgeon will then insert a small tube through the cut. This tube allows fluid to continue to drain from the middle ear to the outer ear and allows air to enter the middle ear.
What happens right after the procedure? This procedure is usually done on an outpatient basis in a same day surgery setting. A person is admitted to the surgery centre, has the procedure, and is then monitored in a surgery recovery room for a few hours. In the recovery room, the person will be monitored for:
reactions to the anaesthesia
bleeding from the surgery site
difficulty breathing
In most cases, once the person is awake and able to drink fluids, he or she can go home from the surgery centre.
What happens later at home? Usually a person recovers within 1 or 2 days after the procedure. Often eardrops are prescribed for the first few days after surgery.
A person will be given special instructions about how to care for his or her ears and tubes. It is important that he or she follow these directions carefully. For instance, a doctor may recommend that he or she:
wear special earplugs when swimming so that water does not enter the ear canal
wear a shower cap when shampooing hair or showering for a few weeks after the procedure
put a small piece of cotton in the ear after showering, shampooing, or swimming to absorb any excess water
What are the potential complications after the procedure? Here are some complications that may occur after ear tubes are inserted:
The person may continue to have ear infections that require antibiotics.
The tubes may come out too quickly. This means that new tubes may need to be inserted if infections continue.
The tubes may have to be removed by a surgeon if they dislodge into the space by the middle ear. If they do not fall out correctly on their own, they also may need to be surgically removed.
Once the tubes fall out, scarring may occur.
Rarely, a small hole may be left in the eardrum. This may require surgery to patch it.
If unusual or foul smelling drainage from the ear is noticed, a person should contact his or her doctor.
Author: Eileen McLaughlin, RN, BSN Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 2/2/2005 Contributors Potential conflict of interest information for reviewers available on request
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