What is ear tube placement?

Ear tube placement is a surgery to treat chronic middle ear infection (acute otitis media) and/or fluid buildup (otitis media with effusion). These conditions can lead to hearing loss, speech problems, and ear structure damage. 

Ear tube placement involves placing tiny cylinder tubes made of metal or plastic through the eardrum (tympanic membrane). Tubes improve airflow in the ear and normalize ear pressure. The medical term for ear tubes is tympanostomy tubes.

Ear tube placement is a common surgery but it has risks and potential complications. Your child may have less invasive treatment options. Consider getting a second opinion about all the treatment choices before having ear tube placement.

Why is ear tube placement performed?

Your doctor may recommend ear tube placement to treat chronic middle ear infection and/or fluid buildup. Your child's doctor may only consider ear tube placement for your child if other treatments that involve less risk of complications have been ineffective. Ask your  doctor about all of your child’s  treatment options  and consider getting a second opinion before deciding on ear tube placement.

Ear tube placement treats the following conditions:

  • Chronic and severe middle ear infection and/or fluid buildup that does not improve with other treatments
  • Eardrum or eustachian tube malformation associated with genetic conditions such as Down syndrome and cleft lip
  • Hearing loss or speech delay due to fluid buildup in the middle ear 
  • Injury to the middle ear due to a reduction of air pressure, which can occur when flying or scuba diving

Who performs ear tube placement?

An otolaryngologist or pediatric otolaryngologist performs ear tube placement. Otolaryngologists specialize in treating conditions of the ears, nose and throat. They are also called ENTs. Pediatric otolaryngologists (pediatric ENTs) specialize in treating ears, nose and throat conditions of infants, children and adolescents.

How is ear tube placement performed?

Your child’s ear tube placement will be performed in a hospital. Your doctor will first use a scalpel or laser to create a small incision in your child's eardrum. This procedure is called a myringotomy. 

Fluid behind the eardrum and in the middle ear space is suctioned out and the area cleaned. The doctor will place a small tube in the hole to allow for drainage and ventilation of the middle ear. 

Your child's doctor may also remove the adenoids (lymph tissue located in the back of the upper throat near the nose) during ear tube surgery. This may help prevent recurrent ear infections and the need for repeat surgery. 

Types of anesthesia that may be used

Children having ear tube placement surgery generally have general anesthesia. General anesthesia includes an inhaled gas and possibly intravenous (IV) medications that put your child in a deep sleep. Your child is unaware of the procedure and will not feel any pain.

Adolescents and adults may not require anesthesia for ear tube placement.

What to expect the day of your child's ear tube placement

The day of the procedure, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your child’s care team will provide blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your child's medical history and the type of anesthesia to be used
  • A surgical team member will start an IV. 
  • The anesthesiologist or nurse anesthetist will start your child's anesthesia.
  • A tube may be placed in the windpipe to protect and control breathing during general anesthesia. Your child will not feel or remember this or the surgery as they happen.
  • The surgical team will monitor your child's vital signs and other critical body functions. This occurs throughout the procedure and your child's recovery until your child is alert, breathing effectively, and the vital signs are stable.