Ear Infections - Surgery

Surgery

Tympanostomy (with Myringotomy)

A tympanostomy involves the insertion of tubes to allow fluid to drain from the middle ear. The procedure involves:

• A general anesthetic (asleep, no pain). Children typically recover completely within a few hours.
• Myringotomy (removal of fluid) is performed first.
• After myringotomy, the doctor inserts a tube to allow continuous drainage of the fluid from the middle ear.

Click the icon to see an illustrated series detailing ear tube insertion.

Postoperative Effects. Tympanostomy is a simple procedure, and the child almost never has to spend the night in the hospital. Acetaminophen (Tylenol, generic) or ibuprofen (Advil, generic) is sufficient for any postoperative pain in most children. Some children, however, may need codeine or other powerful pain relievers.

---

---

Generally, the tubes stay in the eardrum for at least several months before coming out on their own. On rare occasions, they will need to be surgically removed.

Complications. Otorrhea, drainage of secretion from the ear, is the most common complication after surgery and can be persistent in some children. It is usually treated with antibiotic eardrops.

More serious complications from the operation are very uncommon but may include:

• General anesthetic risks. Rarely, allergic reactions or other complications, such as throat spasm or obstruction, may occur. The risk is highest in children who have other medical conditions, most commonly upper respiratory infections, lung disease, or gastroesophageal reflux disorder (GERD). Anesthetic-related risks are nearly always easily treated.
• Tube blockage. Sometimes the tubes become blocked from sticky secretions or clotted blood after the operation.
• Persistent eardrum perforation. This condition occurs when the eardrum does not close after the tubes have come out. It is the most common serious complication, but it is very rare.
• Scarring can also occur, particularly in children who need more than one procedure, but it almost never affects hearing.
• Cholesteatomas, small cyst-like masses filled with keratin (skin cells), develop around the tube site in about 1% of patients.