10 Tremendously Common Ear Tube Questions Parents Frequently Ask

Ear tubes provide an important treatment option for chronic ear infections. Many parents voice  ear tube questions which are important to have addressed prior to surgery. I have discussed important facts about ear infections that parents should know, and also indications to have ear tubes inserted.

As a Pediatric Ear Nose and Throat (ENT) surgeon, with over 25 years of experience, I answer ear tube questions on a daily basis. I strongly suggest you discuss your concerns with your child’s personal ENT surgeon. This blog is intended to provide a foundation to assist in your personal discussions.

10 Tremendously Common Ear Tube Questions Frequently asked by Parents

1. Will the tubes stop ear infections?

No. Ear tubes simply provide a drainage site to allow the ear infection mucous to drain from the middle ear. The tubes allow treatment of the infections with ear drops instead of oral antibiotics.

Ear drainage is NOT normal.  Many patients never have drainage while others have recurrent episodes. The ear drainage may be clear, yellow, green or even bloody. They all represent middle ear inflammation which is treated with drops.

2. Can children hurt the tubes by putting a finger in the ear?

No, your child cannot hurt or dislodge the ear tubes by inserting fingers into the ear. Ear tubes are place directly into the ear drum which is located deep into the ear canal.

If your child inserts a foreign object into the ear, then YES! They could dislodge the tube, but then they could also scrape the ear canal or puncture the ear drum. Needless to say, foreign bodies in the ear canal are discouraged. (This includes Q tips!)

3. Can children feel tubes in ears?

No, typically children cannot feel the tubes once they are inserted. They do not cause pain.

Nevertheless, over time, as the tube is being rejected by the ear drum, dead skin and wax may collect around the tube edges. This collected debris may cause inflammation and intermittent discomfort.

4. Can my child swim without ear plugs?

This topic has been debated for years. Each ENT surgeon has an opinion based on their personal experience. I discussed the details of this situation in my post about 5 fantastical ear tube myths. The basic recap includes a statement from the Academy of Otolaryngology (the governing body for ENT surgeons) which states they do not feel ear plugs are needed.

 5. Will my child need more tubes when these fall out?

80% of children who need ear tubes outgrown their problems and never need tubes again. If your child has ongoing allergy, sinus, adenoid or other problems which impact normal functioning of the Eustachian tube, ear infections may recur after the tube are extruded.

6. Can we put long-term tubes in first time?

Because 80% of children who need tubes, never need a second set, it is extremely uncommon to consider placement of long-term tubes as a first line of treatment

Typical ear tubes are designed to last on average 6 months to one year. Long term tubes (frequently called T tubes) are designed to last 3-5 years and are reserved for patients who continue with ear problems.

7. Can we insert ear tube without going to the operating room?

In the emergency room setting, sedation is quite effective to perform procedures because they have the equipment to monitor your child’s breathing and blood pressure. Most doctors’ offices are not set up to monitor children while sedated.

Without sedation, we need to restrain children to perform surgery. Simple restraining does not remove the wiggling and fighting; thus, it increases risks when the surgeon is making a precise incision in the ear drum.

Consequently, for the vast majority of children, the insertion of ear tubes does require general anesthesia.

8. What can I expect from the surgery and can I stay with my child during surgery?

Some pediatric surgical centers allow parents to accompany their children into the operating room until the child goes to sleep, but then the parents are asked to leave. Once your child is asleep, your continued presence requires operating room staff to monitor you!

Why would staff need to monitor you? Because I have seen moms AND dads pass out during procedures on their children.  Parents then become the focus of medical treatment which distracts from focus on children.

Once children awaken from anesthesia, they join you in a postoperative room and remain with you until they go home. Sometimes children wake up crying and upset, but this is normal and should not cause alarm. The effects from anesthesia can range from nausea, vomiting or no symptoms at all.

The surgery itself lasts only 10-15 minutes, and many children are discharged home in an hour.

9. What causes ear tubes to fall out? What if an ear tube is lying in the ear canal?

As the skin on the surface of the ear drum grows, it slowly pushes the tube into the canal. This process is called extrusion.

Once the tube falls into the ear canal, most children never feel them. However, if the ear canal tubes remain for a long time, they may cause skin irritation and need to be removed in the office.

I believe all children with ear tubes should be monitored by their pediatrician or ENT surgeon until the tubes have extruded.

10. Are there postoperative situations that I should know about?

Many ENT surgeons will prescribe ear drops to be used  after surgery. It is common to have ear drainage for 3-5 days after the surgery.

If your child has an active cold and ear pain the day of surgery, active middle ear inflammation will be present. A larger amount of mucous and bloody discharge may be expected.

Ear tube surgery is not painful.  Teething often hurts more than the surgery. I counsel parents to use pain relievers the same way they did before surgery. The ear tube surgery will add no additional need for pain medication.

Ear tube questions are common for parents who are considering the surgery. I urge you to ask questions to your personal ENT physician.