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Ear, nose and throat (Otolaryngology)

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Myringotomy and tubes

Myringotomy tubes are small tubes that are surgically placed into your child's eardrum by an ear, nose, and throat surgeon. The tubes may be made of plastic, metal, or Teflon®. The tubes are placed to help drain the fluid out of the middle ear in order to reduce the risk of ear infections. These tubes usually remain in place 6-18 months and may fall out by themselves. It is impossible to predict how long a tube will last.

During an ear infection, fluid gathers in the middle ear, which can affect your child's hearing. Sometimes, even after the infection is gone, some fluid may remain in the ear. The tubes help drain this fluid, and prevent it from building up.

About one million children each year have tubes placed in their ears. The most common ages are from 1 to 3 years old. By the age of 5 years, most children have wider and longer eustachian tubes (a canal that links the middle ear with the throat area), thus, allowing better drainage of fluids from the ear.

Who needs ear tubes?

The insertion of ear tubes may be recommended by your child's physician and/or an ear, nose, and throat physician if several of the following conditions are present:

  • Fluid in the ears for more than three or four months following an ear infection
  • Fluid in the ears and more than three months of hearing loss
  • Changes in the actual structure of the eardrum from ear infections
  • A delay in speaking
  • Repeated ear infections that do not improve with antibiotics over several months

The risks and benefits of ear tubes

The risks and benefits will be different for each child. It is important to discuss this with your child's physician and surgeon. The following are some of the possible benefits that may be discussed:

  • Ear tubes help to reduce the risk of future ear infections.
  • Hearing is restored in some children who experience hearing problems.
  • Speech development is not harmed.
  • Ear tubes allow time for the child to mature and for the eustachian tube to work more efficiently. (By the age of 5 years, the eustachian tube becomes wider and longer, thus, allowing for better drainage of fluids from the ears.)
  • Children's behavior, sleep, and communication may be improved if ear infections were causing problems.

The following are some of the risks that may be discussed:

  • Some children with ear tubes continue to develop ear infections.
  • There may be problems with the tubes coming out:
  • The tubes usually fall out in about one year. After they fall out, if ear infections recur, they may need to be replaced.
  • If they remain in the ear too long, the surgeon may need to remove them.
  • After they come out, they may leave a small scar in the eardrum. This may cause some hearing loss.
  • About 30 percent of children with tubes have to have tubes reinserted within five years.
  • Some children may develop an infection after the tubes are inserted.
  • Sometimes, after the tube comes out, a small hole may remain in the eardrum. This hole may need to be repaired with surgery.

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