Tympanotomy with tube insertion
The procedure to treat recurrent ear infection is called tympanostomy with tube insertion. This involves a short surgical procedure in which a small incision is made in the eardrum. The effusion or fluid is suctioned from the middle ear cavity. This allows the eardrum and hearing bones to vibrate normally again. A tube which looks much like a bobbin is placed in this incision to hold the incision open. This is usually an outpatient procedure done under general anesthesia. Afterwards, there is generally very little pain involved and the patient can usually resume all normal activities except those which may pose the risk of water entering the ears.
Most children have no particular problems from this procedure. The following problems, however, can be seen: a) Tubes come out too early...or remain in place longer than desired (probably each occurs about 1-5% of the time); b) Infection; c) chronic perforation of the ear drum - probably occurs in 1-5% of ears. Long-lasting tubes, or large tubes, have a much higher rate of perforation (Up to 10%). These perforations may need to be surgically repaired in some situations; d) scarring of the drum. For the vast majority of patients, this has no clinical or hearing significance.
A tube stays in, on average, about 8-12 months. In certain situations, such as children having multiple sets of tubes, cleft palate patients (who may need tubes for a longer time), or other patients with chronic eustachian tube dysfunction, we may place longer acting tubes which may last for years.
Most experts agree that a routine avoidance of water or use of ear plugs after the tube insertion is NOT necessary. Therefore, Dr. Kim allows bathing, hair washing, surface swimming (head above water), or ocean exposure without any precautions. Diving deeper under water, or swimming with head under water is more likely to cause infections. In those cases, the preventive use of ear plugs is recommended. Custom swim molds may be purchased in our office.
Following the insertion of PE tubes, there isn't much pain. Tylenol should suffice to control any discomfort. Bloody discharge may occur, and it may last for a few days.
Follow-up office visits after the surgery is important. Dr. Kim likes to see his patients about 2 weeks after the surgery, and every 3 months thereafter. Please call Dr. Kim for an appointment.
