A surgical procedure in which a small incision (myringotomy) is made in the eardrum of children with recurrent otitis media or persistent middle-ear effusion to drain fluid and place a thin silicone tube that maintains ventilation.
Indication
- Bilateral serous otitis media (otitis media with effusion) lasting 3 months or longer — especially when associated with hearing loss
- Unilateral middle-ear effusion causing hearing loss for more than 6 months
- Frequently recurring acute otitis media (3 episodes in 6 months or 4 or more in 1 year)
- Children with delayed speech and language development accompanied by middle-ear effusion
- Chronic Eustachian tube dysfunction (persistent ear pain or pressure during air travel)
- Persistent middle-ear problems in high-risk groups such as cleft palate or Down syndrome
- To deliver intratympanic medication (corticosteroids) for some middle-ear diseases
Preparation
- Pediatric ENT examination, otoscopy and audiologic assessment (tympanometry, hearing test)
- If general anesthesia is planned, fasting for 6-8 hours
- The procedure may be postponed if there is an active upper respiratory tract infection
- When adenoid hypertrophy is present, adenoidectomy can be planned in the same session
- Families are informed about post-procedure care (water protection, follow-up)
How it's performed
- Brief general anesthesia is usually preferred in children; topical anesthesia may be sufficient in cooperative adults
- The ear canal is cleaned under microscope and the eardrum is clearly visualized
- A small incision (myringotomy) is made in the eardrum with a specialized scalpel
- Middle-ear fluid (mucoid, serous or purulent) is aspirated
- A pre-prepared silicone ventilation tube is placed through the opening; the tube creates a microscopic 'ventilation window' without supporting the eardrum itself
- Short-term antibiotic ear drops may be applied; no packing is required
Post-procedure
- Most children are discharged the same day
- Mild ear discharge after the procedure is possible; antibiotic ear drops are prescribed
- Earplugs are recommended during swimming and bathing to prevent water entry (per surgeon preference)
- Regular ENT check-ups: first visit at 2-4 weeks, then every 3 months
- The tubes are usually extruded within 6-12 months as the eardrum naturally regenerates; no separate surgery is needed for removal
- Most eardrums close spontaneously after the tube is extruded; rarely a persistent perforation may remain
Risks
- Transient ear discharge and mild infection around the tube
- Early extrusion of the tube (within a few weeks) and need to repeat treatment
- Permanent perforation of the eardrum after the tube extrudes — in a small percentage
- Myringosclerosis (white patches) in the eardrum over time, generally without affecting hearing
- Recurrent discharge after frequent water exposure or unprotected swimming
- Very rarely, cholesteatoma formation (in cases of long-standing tubes or eardrum retraction)
FAQ
How long does the tube stay in the ear?
Standard short-term silicone tubes are usually extruded within 6-12 months as the eardrum naturally regenerates. In high-risk groups, long-term (T-tubes) may be preferred; these can stay in place for up to 2-3 years and are removed by the physician when needed.
Can my child swim or take a bath while the tube is in place?
Most current guidelines do not require earplugs for routine bathing or pool water; however, plugs may be advised for lakes, sea, dirty water, diving and shampoo exposure. The surgeon's individual recommendation should be followed.
Does hearing improve immediately after the tube is placed?
Yes, conductive hearing loss usually improves rapidly once the fluid is drained. Families often notice positive changes in attention and language development.
Do symptoms recur after the tube is extruded?
In some children, fluid or infection may recur because the Eustachian tube has not yet matured; if needed, a second ventilation tube and sometimes adenoidectomy is planned. In most children, the problem resolves spontaneously as they grow older.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Tympanometry
Otorhinolaryngology (ENT)
Tympanometry (middle-ear pressure test) — objective evaluation of eardrum mobility and middle-ear function.
Otoscopy
Otorhinolaryngology (ENT)
Otoscopic examination — basic ENT assessment in which the external auditory canal and eardrum are evaluated with an illuminated magnifier.
EARWAX REMOVAL
Otorhinolaryngology (ENT)
Cerumen removal — safe extraction of earwax obstructing the ear canal using drops, irrigation or curette.
Tympanoplasty
Otorhinolaryngology (ENT)
Tympanoplasty (eardrum repair) — closing the perforation to restore hearing and protection of the middle ear.
Audiometry
Otorhinolaryngology (ENT)
Audiometry (hearing test) — objective evaluation of the type and degree of hearing.
Mastoidectomy
Otorhinolaryngology (ENT)
Mastoidectomy — surgical clearance of the mastoid bone for chronic middle ear inflammation and cholesteatoma.
Epley Maneuver
Otorhinolaryngology (ENT)
Epley maneuver — repositioning of inner-ear crystals in benign paroxysmal positional vertigo (BPPV).
Tonsillectomy
Otorhinolaryngology (ENT)
Tonsillectomy (tonsil surgery) — surgical removal of the tonsils.