Ep. 28: Ear Tube Surgery Secrets: What You Should and Should Not Expect
Ear tube surgery is a very common operation, especially in young children. Because of the large number of viral illnesses that occur during early childhood, ear infections are a common problem. Although most children do indeed outgrow them as they mature, a large number of kids do not.
About half a million ear tube surgeries are performed on children every year; therefore, ear tube surgery is the most common childhood surgery performed with anesthesia. The average age for ear tube insertion is one to three years old.
I have previously shared posts discussing ear infection facts as well as ear infection myths, and complications. Because of the potential for long term problems from chronic middle ear infections, ear tubes can be life-altering for many people.
I have been a practicing ENT surgeon for 30 years and remain amazed by the ongoing misunderstanding about what ear tube surgery will and will not do. The internet is filled with helpful tips from a variety of sources and I have shared posts about ear tubes in general. I also have discussed ear tubes myths and their complications; however, I must emphasize that your best source of information is YOUR PERSONAL surgeon!
I love to teach so I spend a large portion of my office visit with parents educating them about their child’s medical problem and treatment. I also share tips on preventing ear infections because, as I will soon discuss, ear tubes do not stop ear infections. Awww yes! This is the most shocking statement I say. Every. Single. Day.
I get it. Parents want these ear infections to disappear, but as with most medical problems, there is no magic. So, let me give you a peek into the discussions that I share with my patients about ear tube surgery to help them understand how I can help participate in their child’s healthcare.
**Please be sure to listen to the audio part of this post found here because I expand upon each topic in much more detail.**
WHAT YOU SHOULD EXPECT FROM EAR TUBE SURGERY
Before the surgery:
- Be prepared to share the history of ear infections
- Know the names and doses of all medications
- Report ALL medical problems, I mean ALL, not just those related to ENT!
- Will be given instructions about when and what your child may eat or drink before surgery. MEMORIZE THIS OR SURGERY COULD BE CANCELLED!
- Arrive on time because of a lot needs to happen before surgery starts. If you are late, SURGERY MAY BE CANCELLED.
- Know when you will get medications to be used after surgery. During the pre-surgery office visit, I always send medications to the pharmacy so that parents can avoid the need to stop at the pharmacy after surgery.
- There are many different types of ear tubes that last for different lengths of time. Ask your surgeon what type of tube your child is going to have.
- You should absolutely have time to meet your anesthesia team and understand their credentials before surgery begins. It is usually not possible to meet them until the day of surgery but you should have time to talk to them before surgery starts.
During the surgery
- Ear tube surgery is VERY quick, like 5-10 minutes.
- Typically, no IV needs to be placed into your child’s hand, and no breathing tube is placed in the throat. (Notice I said typically. If there are other medical concerns, the anesthesiologist will let you know why they may need to deviate.)
- This surgery is most commonly done in an outpatient surgery center. Yes, it can be done in a big hospital setting and many parents feel comforted by being in a hospital, but a free-standing surgery center that has anesthesia staff trained to take care of kids…perfect place.
- Some places allow parents to go into the operating room with their child while they are breathing in the laughing gas (this a really sweet name for anesthesia, so you might as well say anesthesia). Many, many places do not let parents go back. KNOW BEFORE SURGERY IF YOU CAN OR CANNOT GO BACK.
- Your child will not be left alone. A member of the healthcare team is with your child at all times.
- Using a microscope, a cut is made on the eardrum and the ear tube is inserted into the eardrum.
- Usually, ear drops are placed by the surgeon at the time of surgery
After the surgery
- Some outpatient centers bring children directly to their parents as soon as surgery is done. Others have the kids go to a recovery area for monitoring before bringing the child to see the parents.
- Kids usually have very little pain, but could be groggy, and irritable or might have nausea as the anesthesia leaves their body.
- Most families are ready to go home within an hour after their child is drinking fluids without nausea or vomiting.
- Many physicians recommend using ear drops after surgery. Be sure you understand how often and how long the drops should be used
- Bloody drainage from the ear is normal
- The cotton ball placed in the ear is like putting a bandaid on a cut. No necessary, but soaks up some of the fresh blood and drainage.
- Ear drops usually do not burn, but some of them do. Check with your surgeon to see what you should do if your child experiences pain with the drops.
- This is typically NOT a painful procedure but pain can be a personal thing. You may use Tylenol or Motrin as needed.
- Hearing loss due to ear fluid is almost immediately resolved but a hearing test will still need to be done later to ensure hearing is completely normal. Your surgeon will let you know when the hearing test should be scheduled
- The Academy of Otolaryngology no longer recommends earplugs when taking a bath, shower or when swimming. WooHoo! Freedom from plugs and swim caps is a good thing. Many surgeons have stopped recommending plugs but check with your surgeon to see if they recommend them or not.
WHAT YOU SHOULD NOT EXPECT FROM EAR TUBE SURGERY
- Infections may still happen, but now they can drain through the tube and be treated with antibiotic ear drops
- Ear tube surgery does NOT impact a chronic runny nose.
- Ear tube surgery does NOT make a chronic cough go away.
- Tubes are not permanent. They are a temporary drainage site until the child outgrows the problem or another problem is treated. They will either fall out on their own or they will need to be removed.
- We do not have any secrets to make tubes last longer in the eardrum.
- We also do not have any secret to making the hole close up after the tube falls out. It may need surgery to repair the hold.
- There is no maximum number of ear tubes that can be placed. Some people need them as teens as adults.
- Ear pain may still happen. There are many causes of ear pain.
- Ear tubes should be evaluated periodically until they fall out or are removed. Ask your surgeon how often they should be checked.
- Speech, language, learning and balance problems often do not resolve right away and may take weeks to months to see improvements. Some kids need therapy to help restore them to normal milestones.
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