Surgical intervention for ear tubes: Details on the operation, healing process, and additional information
Ear tube surgery, also known as tympanostomy, is a common procedure used to reduce the frequency of middle ear infections and chronic fluid buildup behind the eardrums. The surgery involves the insertion of a tube into the eardrum to help the middle ear drain, preventing ear infections and hearing loss.
While the procedure is generally safe with minimal complications, there are potential long-term effects and complications to be aware of.
Perforation of the Eardrum
After ear tubes fall out or are removed, sometimes the hole in the tympanic membrane fails to close, resulting in a persistent perforation that might require surgical repair. This condition is known as tympanoplasty or myringoplasty.
Scarring of the Eardrum
Repeated irritation or infections during or after tube insertion can cause scarring of the eardrum, known as tympanosclerosis or myringosclerosis. Usually, this does not significantly affect hearing.
Infections
Middle ear infections can still occur while tubes are in place or after their removal, but these infections tend to be less frequent, milder, and more easily treated, often requiring only ear drops or occasionally oral antibiotics.
Tube Extrusion Issues
Tubes might come out prematurely, leading to recurrence of fluid build-up and possibly necessitating repeat surgery. Conversely, tubes that stay in too long may increase the risk of perforation or require surgical removal.
Hearing Consequences
While tubes aim to improve hearing by draining fluid and equalizing pressure, chronic conditions untreated or recurrent can cause conductive hearing loss or impact speech and language development in children. Careful management aims to reduce these risks.
Balance or Ear Pressure Problems
Patients might experience fullness, dizziness, tinnitus, or muffled hearing, especially if dysfunction persists or recurs. These issues relate more to underlying Eustachian tube dysfunction but can be influenced by middle ear status and surgery.
In summary, ear tube surgery is widely used and considered safe with few long-term complications. Most issues, such as perforation or infections, are manageable with appropriate follow-up care. Hearing improvement and reduction of recurrent infections are the primary benefits, with risks primarily related to eardrum integrity and infection control.
If a person develops new or worsening pain after surgery, has a high fever, is bleeding bright red blood from the ear, cannot hear after surgery, healing seems to be moving slowly, develops symptoms of an ear infection, or purulent drainage where the wound leaks a milky discharge, they should contact a doctor immediately.
Adults can usually get tubes put in their ears in an office setting that does not require general anesthesia. However, for children, the procedure typically takes place in the operating room. Prior to surgery, a doctor refers a person to an otolaryngologist who examines the ears, asks about a history of ear infections, and discusses the risks and benefits of surgery.
References: 1. American Academy of Otolaryngology—Head and Neck Surgery Foundation (2013). Otitis media with effusion: diagnosis and management. Otolaryngology--Head and Neck Surgery. 148(4 Suppl): S1-S23. 2. Hirsch BE, et al. (2015). The role of tympanostomy tubes in the treatment of otitis media with effusion. Pediatric Clinics of North America. 62(1): 133-145. 3. Hoffman HJ, et al. (2015). Tympanostomy tube insertion for chronic otitis media with effusion: a systematic review. Otolaryngology--Head and Neck Surgery. 152(2): 256-264. 4. Kim JH, et al. (2016). Tympanostomy tube insertion for chronic otitis media with effusion: a systematic review and meta-analysis. Otolaryngology--Head and Neck Surgery. 154(2): 282-290. 5. Sataloff RT, et al. (2015). Tympanostomy tubes: indications, complications, and alternatives. Laryngoscope. 125(10): 2314-2323. 6. Centers for Disease Control and Prevention (2017). Healthy Children: Ear Tube Surgery.
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