You or your child had tubes inserted into the eardrum. The purpose of tube placement is to allow pressure equalization to occur, which can prevent fluid buildup in the middle ear or prevent significant negative pressure buildup in the ears. This can also help to stave off middle ear infections (otitis media) in patients who have recurrent infections. The tubes will usually extrude from the eardrum in 6-12 months, but sometimes tubes will stay in the eardrum for longer or shorter periods of time.
You almost always will have antibiotic eardrops either prescribed for you or given to you in the recovery room. Sometimes, we prescribe antibiotic eyedrops instead of eardrops to save money. You should use the eardrops about 4-5 drops into each ear twice daily for 3-10 days, depending on the instructions from the doctor.
It is important to keep your follow up appointment with the doctor so that the tubes can be inspected. These appointments usually are 2-3 weeks after the procedure and every 4-6 months thereafter until the tubes come out. After the tubes come out, it is also important to follow up to see what happens with the eardrum. Audiograms (hearing tests) may be done at intervals during the follow up period.
Do I need to be careful swimming after tube placement?
The guidelines from the main ENT academy state that it is not necessary to wear waterproof ear plugs when swimming while tubes are in place. The opening of the tube is very, very small and the surface tension of the water usually prevents the water from going into the tube. Soapy water has less surface tension and is more likely than non-soapy water to get into the tube. Sometimes, water will get into the ear canal and into the middle ear via the open tube and can lead to an infection, which is usually manifest by drainage from the ear.
My usual advice is to attempt to swim as normal, without earplugs, but if water gets in and is bothersome to you or get an infection, I would use waterproof earplugs, likely with an “ear band” or a swim cap that pulls far down over the ears (may have a cutout of the external ear on the cap) to keep the earplugs in.
If there is drainage or bleeding from the ear months after tube placement
As the eardrum pushes out the tube, it could form granulation tissue around the base of the tube. This tissue will often weep yellowish-white fluid and sometimes there can be bleeding from here. This is usually helped with the application of antibiotic and steroid eardrops (or eyedrops) for 10 days or so. This will calm down and melt away the granulation tissue. If the granulation tissue is persistent despite treatment, the tube may need to be removed from the eardrum.
Can I have a permanent hole in the eardrum after tube placement?
The risk of a perforation in the eardrum after tube placement is about 2%. If this happens, if the hole is small, and you always need a tube to ventilate the eardrum, it may be a good thing for you because the hearing is usually not very compromised by a small hole and you also have the benefit of ventilation. The hole can also be patched with a piece of paper or sometimes a small piece of fat from the earlobe, if small.
However, sometimes the hole can become large and lead to worsened hearing and higher propensity for drainage/infection. If this happens, you or your child may need formal tympanoplasty surgery to repair the perforation.
Brian Kung, MD 