Otitis Media (Middle Ear Infection) and Tubes

A middle ear infection is one of the most common reasons for a child to visit a doctor. Roughly 75% of all children experience at least one during their life. The underlying reason for this is that the Eustachian tube that drains the middle ear and equalizes the middle ear pressure isn’t fully developed until you are 3-5 years old. Most of these ear infections can resolve on their own. Antibiotics can help shorten the duration and help with symptoms. Adults can also get ear infections if their Eustachian tubes aren’t working well.

A myringotomy (making an incision in the ear drum) with placement of a tube is a simple procedure that bypasses the natural Eustachian tube. This allows air pressure to equalize in the middle ear and allows any future infection to drain out. It also helps the hearing since the fluid which muffles hearing is removed at the time the tube is placed. This procedure is recommended for children with frequent ear infections or for fluid from a previous infection that doesn’t clear over time. In adults, this procedure can usually be done in the office with a local anesthetic. In children, tubes are placed under anesthesia in an operating room. Having a tube in the ear can greatly reduce, if not eliminate, the number of infections as well as the symptoms from them.

There are 2 main types of tubes used. Some are designed to fall out on their own after 6-24 months and the other is more permanent (usually used if multiple sets of tubes have been needed). Once the tube falls out, 95% of the time the hole in the ear drum closes up on its own. In 85% of children, one set of tubes is sufficient to allow time for the Eustachian tube to mature.

If you happen to get an ear infection while tubes are in place, drainage from the ear is the most common symptom. Antibiotic ear drops are the main treatment at this point. It provides a higher concentration of medicine into the ear and reduces the chance that a tube might become occluded by dried secretions. Ideally, you shouldn’t need oral antibiotics if you have tubes in place.