What is ear tube surgery?
Ear tube surgery is an outpatient procedure to place tubes in your child’s ears. Your child may need ear tube surgery if they have recurring ear infections that don’t respond to antibiotics or have fluid buildup in their ear that limits their hearing.
The purpose of the ear tube is to equalize pressure between the middle ear and the environment. The ear tubes allow pressure behind the eardrum to equalize, extra fluid from the infection to drain out, which reduces inflammation and allows the ear to heal. This procedure can help decrease ear infections and resolve symptoms such as hearing loss.
There are two types of procedures we use to insert ear tubes: placement using traditional ear tube surgery and placement using an in-office procedure.
How to decide between traditional ear tube surgery and in-office ear tube placement
For in-office ear tube placement, your child’s doctor needs to use a microscope to clean the ear, must place topical anesthesia and insert the tube using a device similar to a needle. To do this, they may need to lightly restrain your child during the procedure, like they might do for a blood draw or vaccination. For this reason, children younger than 18 months are usually the best candidates.
Since in-office ear tube placement does not involve going to the operating room or using general anesthesia, this procedure can usually be done at a much lower cost. Since most health insurance usually covers both procedures, this may or may not be significant to you depending on your situation.
In-office ear tube placement
For in-office ear tube placement, your child’s ear, nose and throat (ENT) surgeon inserts the ear tubes using a topical anesthetic rather than general anesthesia, which is used in traditional ear tube surgery. A topical anesthetic numbs the area around where the procedure will take place. Your child will be awake during the procedure and will feel some discomfort. The discomfort is very brief and like the pain your child might feel from a vaccination or blood draw. In-office placement doesn’t require an operating room like traditional ear tube surgery.
The device used for the in-office procedure is similar to a needle with which your child’s surgeon will place the tube into the ear. The procedure usually takes about 5 to 10 minutes.
What to expect during and after in-office ear tube placement
The procedure can be done in a doctor’s office, and you can be with your child during the ear tube placement. A specially trained ENT surgeon performs the procedure. Your child will be laying down for the procedure. After your child’s surgeon removes any ear wax and applies a topical anesthetic to the eardrum, the surgeon will use a special device to insert the tube. Sometimes it helps to bring a video for your child to watch or something to distract them during the procedure.
Since there isn’t a general anesthetic being used, your child will be free to leave the hospital and get back to their day as soon as the procedure is finished. Your child will most likely have little to no pain but may complain that sounds are louder. Over the next couple days, fluid may drain from your child’s ears, and antibiotic ear drops may be prescribed until the drainage stops.
Ear tube surgery
How do I help prepare my child for traditional ear tube surgery?
Your child’s providers will tell you when your child should stop eating and drinking before surgery. Your child shouldn’t eat or drink too close to the time of surgery, including gum, candy or mints. If your child’s stomach isn’t empty at the time of anesthesia, the stomach contents can come up and enter the lungs. This is called aspiration, which can cause serious health problems. If food or liquids are ingested too close to the time of surgery, the surgery will be rescheduled.
What happens during traditional ear tube surgery?
Ear tube surgery is usually done under general anesthesia. Anesthesia is the use of medicines called anesthetics to keep your child from feeling pain during a procedure. In addition to making your child not feel any pain, general anesthesia will also help them sleep through the procedure.
Your child's surgeon will make a small incision in the eardrum and clean fluid out of the middle ear. The surgeon will then place a small, hollow tube in the incision, usually made from surgical-grade plastic or metal. The surgery takes about 10 minutes.
The surgeon may recommend that your child have an adenoidectomy, a surgery to remove the adenoid, at the same time as ear tube surgery. The adenoid is a small patch of tissue located behind the nose that helps fight off infection by trapping bacteria that enter through the mouth, and in some cases, bacteria can get trapped in the adenoids and lead to chronic infections.
An adenoidectomy may be recommended if your child needs a second set of tubes or has significant nasal blockage from enlarged adenoids.
What to expect after traditional ear tube surgery?
Anesthesia from surgery may cause your child to feel nauseous, groggy or be irritable right after surgery. Our care team will watch your child closely while they recover until your child can go home.
Ear tubes generally stay in place for six to 12 months, then fall out on their own. The most common risk of the procedure is ear drainage, which generally responds to antibiotic ear drops. Rarely, in about 1% of children, a small hole may remain on the eardrum after the tube falls out.
Your child's surgeon will see your child again three to four weeks after surgery to make sure the tubes are working well and to do a hearing test. After that, your child will have follow-up appointments every nine to 12 months until the tubes have fallen out. There is a 30% chance that your child will need more than one set of tubes.
How do I care for my child at home after traditional ear tube surgery?
Your child will most likely have little to no pain. They may have a mild fever or complain that sounds are louder. They may also eat less than normal.
Fluid may drain from your child’s ears for two to three days after surgery. Your child’s doctor may prescribe antibiotic ear drops for a few days until the drainage stops.
Why choose Children’s Colorado for my child’s ear tube surgery?
At Children’s Colorado, we specialize in pediatric care. From the moment you walk into our hospital, we are focused on providing a pleasant and kid-friendly experience for your child.
Our ENT surgeons are experts in their fields and are supported by a dedicated team of pediatric anesthesiologists, nurses and child life specialists who all work together to make your child’s ear tube procedure as comfortable as possible.
Ear tube surgery is one of the most common outpatient surgical procedures that our pediatric otolaryngology doctors perform. In addition to traditional ear tube surgery, we’re happy to offer in-office ear tube placement using a special device. This device allows us to insert ear tubes in a matter of minutes without using general anesthesia. This is great news for children who can’t tolerate general anesthesia. Even for children who deal well with general anesthesia, the on-office procedure doesn’t require your child to fast beforehand and they can leave immediately after the procedure, unlike traditional ear tube surgery.
Contact us
Call us at 720-777-8501 to schedule an appointment for ear tube surgery.
If you have any questions or concerns, call the ParentSmart Healthline toll free at 1-855-KID-INFO (543-4636). Caring pediatric nurses are available 24/7 to help answer your questions.