Ear tubes 201: Is surgery for ear ventilation tubes safe?

ear-tube-surgeryYour child has persistent ear infections. She pulls on her ears. A lot. She has a runny nose. Almost all the time. So your doctor recommends surgery to place ventilation tubes in her ears.

Should you worry?

In this second of a three-part series, D. Randall Pinkston, MD, Otolaryngologist, discusses surgery for placing ventilation tubes in a child’s ears.

Ventilation tubes are often recommended for children who experience persistent ear infections. The tubes ventilate the ears so that infection has a minimal chance of recurring.

What Are the Ventilation Tubes Like?

  • They’re tiny—just big enough to let air get behind the eardrum. The inner diameter is just a little over 1 mm.
  • They’re generally made of plastic, such as Teflon. Some are made of metal (titanium).
  • They’re shaped like a grommet or a spool.

Is Placing the Ventilation Tubes in the Ear a Surgical Procedure?

Yes, ventilation tubes require surgery and the use of anesthesia, because, as Dr. Pinkston says, “in small children, the eardrum is smaller than my pinky fingernail, and I’m operating on it through a microscope where any movement at all is like an earthquake. So it’s critical that the child be absolutely immobile while I’m operating.”

“It’s very, very safe.”

The procedure is quick—taking only 15 minutes—including:

  • Becoming sedated
  • The surgery itself
  • Waking up from the anesthesia

What Are the Expected Results of a Successful Ventilation Tube Surgery?

  • Few or no ear infections after the surgery
  • A normal hearing test (audiogram) in both ears (if there was excess fluid)

What Are the Risks for the Surgery?

Dr. Pinkston said the risks are few for ventilation tube surgery. It’s a safe procedure. But he listed these possible results for ventilation tube surgery in an otherwise healthy child:

  • Persistent infections
    • Surgery unsuccessful; child still gets ear infections
    • Child still needs antibiotics and ear drops
    • Occurs in about five percent of cases
  • Tube blockage
    • Dried blood or mucus from the surgery blocks the tube
    • Can often be removed in the doctor’s office
    • Occurs in about 10 percent or fewer of cases
  • Premature tube extrusion
    • Tube falls out too soon
    • Very rare at Scott & White
  • Perforated eardrum
    • A hole in the eardrum where the tube had been
    • Requires additional surgery to repair
    • Occurs in about two percent of cases, though risk increases with each additional ventilation tube surgery
  • Any anesthesia risks

“In a healthy child, undergoing anesthesia at a pediatric surgery center like Scott & White has—where all of the attending anesthesiologists are pediatric trained—the risks are as close to zero as you can imagine. It’s very, very safe,” says Dr. Pinkston.

At What Age Are Ventilation Tubes Recommended for a Child with Persistent Ear Infections?

Dr. Pinkston says otherwise healthy infants as young as 9 or 10 months may receive ventilation tubes to prevent persistent ear infections and fluid build up in the middle ear. Peak usage of tubes is around 1 to 2 years, tapering off around age 3 or 4.

However, Dr. Pinkston says he places ventilation tubes in patients well into their 80s if they have poor-functioning eustachian tubes.

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Ear tubes 201: Is surgery for ear ventilation tubes safe?