Ear tubes (tympanostomy tubes, ventilation tubes, pressure equalization tubes) are tiny cylinders, usually made of plastic or metal, that are surgically inserted into the eardrum. An ear tube creates an airway that ventilates the middle ear and prevents the accumulation of fluids behind the eardrum.
Ear tubes are often recommended for children who have persistent fluid buildup behind the eardrum, especially if the condition causes hearing loss and affects speech development. Your child's doctor may also recommend ear tubes if your child gets frequent ear infections.
Most ear tubes fall out within six to 12 months, and the holes heal shut on their own. Some tubes need to be removed, and some holes may need to be closed surgically.
An ear tube is used most often to provide long-term drainage and ventilation to middle ears that have had persistent fluid buildup, chronic middle ear infections or frequent infections.
Normal ear ventilation
Ventilation of the middle ear is normally accomplished by the eustachian tubes, a pair of narrow tubes that run from each middle ear to high in the back of the throat. The throat end of the tubes opens and closes to:
- Regulate air pressure in the middle ear
- Refresh air in the ear
- Drain normal secretions from the middle ear
Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory infection or allergy can block them, causing the accumulation of fluids in the middle ear. This problem is more common in children, in part, because their eustachian tubes are narrower and more horizontal — factors that make them more difficult to drain and more likely to get clogged.
Ventilation with ear tubes
Ear tubes provide an alternative airway to keep the air in the middle ear refreshed, allow for normal drainage and equalize the pressure in the ear. The tubes are most often used in children with one of the following conditions:
- Fluid trapped behind the eardrum is inflammation and fluid buildup (effusion) in the middle ear without bacterial or viral infection. This may occur because the fluid buildup persists even after an ear infection has resolved. It may also occur because of some dysfunction or noninfectious blockage of the eustachian tubes.
- Hearing loss often results from otitis media with effusion. Hearing loss can lead to delays in speech development, communication problems, behavior problems and poor school performance.
- Middle ear infections are generally considered frequent if there are three or more distinct episodes in six months or four or more episodes in a year. Ear tubes may help prevent recurring infections.
- Chronic middle ear infections are long-term infections of the middle ear that don't improve with antibiotic treatment.
- Chronic suppurative otitis media is a persistent ear infection that results in tearing or perforation of the eardrum.