Ventilation tubes are small, hollow tubes often made of plastic or metal that are inserted in the eardrum. They are also called ear tubes, tympanostomy tubes or grommets. The opening allows air to flow into the middle ear and enables drainage of the middle ear. This prevents the build-up of fluid behind the eardrum.
They are often recommended for children with recurrent fluid build-up behind the eardrum, especially if it causes hearing loss or affects speech development.
Ventilation tube placement is one of the most common surgeries in children. However, they may be required in adult patients too.
Difference between a Myringotomy and Tympanostomy
Myringotomy is a standalone procedure that involves making an incision in the eardrum to drain excess fluid from the middle ear. However, a Tympanostomy is when ventilation tubes are inserted in the eardrum.
Why do I need a Tympanostomy?
A ventilation tube is used to treat and prevent the collection of fluids in the middle ear.
The Middle Ear
The middle ear involves the area behind the eardrum containing three small vibrating bones (ossicles) A tube connecting the back of the throat to the ear opens in the middle ear. This tube has three primary roles:
- Allow air into the middle ear.
- Allow fluids to drain from the middle ear into the throat.
- Equalize the pressure in the middle ear.
Problems with the middle ear
Conditions treated with ventilation tubes usually have two features:
- Inflammation (Otitis media)
- The build-up of fluids (Effusion)
Ventilation tubes may be used to treat the following symptoms:
- Middle ear infection (Acute Otitis Media) is caused by bacteria or viruses. The infection causes inflammation and fluid build-up in the middle ear. Ventilation tubes may be used to prevent new infections.
- Otitis Media with Effusion is the collection of fluids without the signs or symptoms of an infection. This could occur due to persistent fluids after an infection, an issue with the eustachian tube or some other condition preventing drainage. This fluid can cause hearing loss and balance-related problems.
- A chronic middle ear infection is a bacterial infection that does not respond to antibiotics. A ventilation tube may be placed to drain the ear and allow antibiotic drops to directly enter the middle ear.
- Chronic Suppurative Otitis Media is the ongoing inflammation of the middle ear resulting in a perforation in the eardrum and persistent ear discharge. It could be caused by an infection, injury to the ear or a blockage of the eustachian tube. Ventilation tubes enable drainage after the eardrum is surgically repaired and allows for drops to be applied directly to the middle ear.
How is the surgery performed?
Ventilation tube placement is usually performed under general anaesthesia. However, local anaesthesia may be used for adults depending on the situation.
During the surgery, a small incision will be made in your eardrum. The fluid that is accumulated behind the eardrum is drained. The surgeon then inserts the ventilation tube into the incision in the eardrum allowing the fluid to drain.
At times, a ventilation tube placement may be performed along with an adenoidectomy. This is especially the case if you’ve had a ventilation tube inserted previously. The removal of adenoids may prevent the need for future ventilation tube surgeries.
Ventilation tube placement surgeries may be performed in the operating room or on an outpatient basis. It usually takes less than 15 mins and since it is a day-care procedure, you can go home the same day.
What are the risks or possible complications of a Tympanostomy?
As with any surgery, there is a certain degree of risk. Some of these include:
- The hole in your eardrum may not close after the tube comes out. In such cases, the hole has to be closed with another surgery.
- Eardrum scarring is caused by the surgery itself or due to multiple ear infections.
- Recurrent ear infections, even after a Tympanostomy.
- Otorrhoea (fluid discharge from your ear).
- Your eardrum may harden or shrink after multiple ventilation tube surgeries.
- The ventilation tubes may get clogged by ear wax.
- The tube may fall out too soon, in which case, another needs to be put in the eardrum.
- At times, a tube does not fall out and needs to be surgically removed.
You should see your doctor outside of your scheduled follow-up if you experience:
- Brown, yellow or bloody discharge continues for over a week.
- Persistent hearing problems, pain or balance problems.
What are the advantages of Tympanostomy surgery?
A ventilation tube placement surgery offers significant benefits to the patient:
- A reduction in the risk of recurrent ear infections.
- Reduced need for oral antibiotics during treatment.
- Less pain during the infection.
- Lower fevers during the infection.
- Improvement in hearing.
- Improvement in speech.
- Reduced risk of sleep problems associated with chronic ear infections.