Myringotomy with Tube Insertion

What is Myringotomy with Tube Insertion (Ear tubes)?

Myringotomy is the name for an incision made in the eardrum. A small tube is then usually placed into the incision to keep it from closing. Tubes are made of various materials, and are of different sizes and shapes. A tube maintains the opening in the eardrum for both ventilation and drainage purposes. A myringotomy with or without tube insertion typically requires general anesthesia in children. Tube placement usually takes approximately 15 minutes in the operating room and is performed as an outpatient procedure.

What are the advantages of ear tubes?

Tubes have been shown to decrease the frequency, severity, and duration of ear infections. Also, in children with chronic fluid behind the eardrum and hearing loss, tubes can keep the ear free of fluid and improve the hearing.

If a child with ear tubes does get an ear infection, this usually presents with ear drainage. Infections should be treated with ear drops, as the tube allows the drops to penetrate into the middle ear, where the infection is located. Oral antibiotics may still be needed if another area is also infected, such as the sinuses or lungs, or if the ear drainage does not resolve with drops alone.

What are the disadvantages of ear tubes?

In rare cases, the tube does not fall out and may have to be removed. Also, in rare cases, the eardrum does not heal completely and may require another surgery to repair it. Children with tubes may get scarring on the eardrum called "myringosclerosis." This usually does not affect the hearing.

How long do the tubes last?

Standard tubes typically remain functional for 6 to 18 months while some smaller tubes have a shorter duration of 6 to 12 months. The tube usually falls out on its own, and the ear drum heals within a few days. In most cases, by the time the tube falls out, the patient has grown out of the underlying problem and will no longer get frequent ear infections. "Long term" tubes, typically used in older children or in other special circumstances, can remain in place for years and may require a second operation for removal.

Can my child get their ears wet with tubes?

Bathing and swimming is usually not a problem for young children (less than 3) with ear tubes. In older children who may be diving deeper under water, ear plugs should be used to keep water out and prevent ear infection or drainage. Also, caution is advised with swimming in freshwater ponds or streams which may have more abundant bacteria.

Can my child fly with ear tubes?

Yes. Ear tubes allow pressure to equalize across the eardrum, and your child should not experience pain from pressure changes while flying.

Pre-operative Instructions and Restrictions:

In the days preceding surgery, your child may take acetaminophen (Tylenol, Tempra, and Panadol), prescribed antibiotics, or an over the counter cold medicine as long as it does not contain aspirin or ibuprofen. Please notify your doctor if there is a family history of bleeding tendencies or if your child tends to bruise easily.

The following should not be ingested within 14 days of your child's surgical date:

  • Aspirin (including Pepto-Bismol)
  • Ginkgo Biloba
  • St. John's Wort

The following should not be ingested within 7 days of your child's surgical date:

  • Anti-inflammatory medications (Naproxyn, Aleve, Celebrex, etc.)
  • Ibuprofen products (Children's Motrin, Children's Advil, etc.)

Postoperative Care Instructions:

  • Following the procedure, first introduce a clear liquid diet, progress to a light diet, and then to a normal diet as the child feels like eating.
  • Tylenol or ibuprofen may be taken to ease postoperative discomfort.
  • If nausea and/or vomiting persist for 12-24 hours, please call the office nurse.
  • Your child may experience drainage of fluid from the ear for 2-4 days following the procedure. The drainage may be clear, pink, green, yellow, or bloody, and may be crusted or dripping.
  • Use ear plugs and ear drops as directed by your physician.
  • Your child will need to be seen 2-4 weeks after surgery. Please call the office to set up an appointment.
  • If there is any drainage from the ears after the initial 2-4 days, contact the office nurse for instructions.