Ear Infections: Surgery

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Surgery

Surgery for middle ear infections (acute otitis media) often means placing a drainage tube into the eardrum of one or both ears. It's one of the most common childhood operations. While the child is under general anesthesia, the surgeon cuts a small hole in the eardrum and inserts a small plastic tube in the opening (myringotomy or tympanostomy with tube placement).

The tubes will ventilate the middle ear after the fluid is gone. They help relieve any hearing loss. Children who have ear infections often develop fluid behind their eardrum (otitis media with effusion) and hearing loss. The hearing loss is usually temporary, but it's more of a concern in children age 2 and younger. Normal hearing is important when young children are learning to talk.

Doctors consider tube placement for children who have had repeat infections or fluid behind the eardrum in both ears for 3 to 4 months and have hearing loss. Sometimes they consider tubes for a child who has fluid in only one ear but also has hearing loss.

Surgery Choices

Inserting ear tubes (myringotomy or tympanostomy with tube placement) often restores hearing and helps prevent buildup of pressure and fluid in the middle ear.

Adenoid removal (adenoidectomy) or adenoid and tonsil removal (adenotonsillectomy) may help some children who have repeat ear infections or fluid behind the eardrum. However, doctors tend to suggest these surgeries only after tubes have failed to prevent repeat ear infections.¹ Children younger than 4 don't usually have their adenoids taken out unless they have severe nasal blockage. Taking out the tonsils alone is not very helpful.⁸

What To Think About

Most tubes stay in place for about 6 to 12 months, after which they usually fall out on their own. After the tubes are out, the hole in the eardrum will close in 3 to 4 weeks. Some children need tubes put back in their ears because fluid behind the eardrum returns.

In rare cases, tubes may scar the eardrum and lead to permanent hearing loss.

Doctors suggest tubes if fluid behind the ear or ear infections keep coming back. Learn the pros and cons of this surgery. Before deciding, ask how the surgery can help or hurt your child and how much it will cost.

Surgeons will sometimes operate to close a ruptured eardrum that hasn't healed in 3 to 6 months, though this is rare. The eardrum usually heals on its own within a few weeks.

If your child has a ruptured eardrum or has ear tubes in place, keep water from getting in the ear when your child takes a bath or a shower or goes swimming. The ear could get infected if any germs in the water get into the ear. If your doctor says it’s okay, your child may use earplugs. Or your doctor may have other advice for you. He or she can tell you when the hole in the eardrum has healed and when it’s okay to go back to regular water activities.

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Last updated:	February 28, 2007
Author:	Debby Golonka, MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Charles M. Myer, III, MD - Otolaryngology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman