Ears

  • What to expect when your child is having ear tubes

    During your office visit, we will discuss the different facilities in the area where we can do your surgery.  Once you decide on a facility and a date, our office will schedule the procedure.  Prior to the day of surgery, you will get a call from the facility.  They will ask some of your child’s health history and will give you specific instructions on when to not let your child have anything to eat or drink prior to surgery.  The day before your surgery, you will get another call from the facility telling you the specific time that you need to arrive.  We arrange the schedule by age so that younger children go first.

    The day of surgery

    • The most important thing parents can do is to help keep their child calm.  It is normal to be nervous when your child is having surgery but the more calm you are, the more your child will be at ease.
    • Once registered at the facility, your child will change into a hospital gown.
    • The anesthesiologist and anesthetist will meet with you and answer any questions you have regarding anesthesia and sedation.
    • Parents can stay with their child right up to the time that they are taken to the operating room.
    • Your child can bring along a comfort item, such as a stuffed animal, if they like.
    • You should expect to go home soon after the surgery is over.

    What to expect after surgery

    • Children are often irritable immediately after surgery.
    • It is not uncommon to have some intermittent fever immediately after the surgery.  As long as it is controlled with Tylenol or ibuprofen, there is no need for concern.
    • Our office will call and check on your child.
    • There should be little to no pain after the surgery.
    • Your child can resume normal activity as soon as they feel up to it.
    • There is no need for routine water precautions.  Children with tubes can bathe and swim normally with very few exceptions.
    • It is possible to get an ear infection with ear tubes.  If this happens, you will see some drainage from one or both ears.  The drainage can be bloody.  If this occurs, you should not be alarmed.  The treatment is a course of eardrops.
    • The tubes will fall out, usually after about a year.  If they stay in the eardrum longer than 2 years, which is very uncommon, we recommend that they be removed.
  • When should I consider ear tubes for my child?

    Children who have a middle ear effusion (fluid behind the ear drum) for at least three months and documented hearing impairment are candidates for tube placement.  Continuing to watch and wait for the fluid to resolve is also an option and should be considered if there is no or minimal hearing impairment.

    Children with middle ear effusions for at least three months and symptoms such as pain, dizziness, poor school performance, etc. should also be considered for tubes.

    The American Academy of Otolaryngology-Head and Neck Surgery practice guidelines are linked below and provide additional detail.

    How will my child be put to sleep?

    Your child will breathe an anesthetic gas through a mask.  It only takes about three full breaths for your child to be asleep so the process is very quick.  Some children benefit from sedation prior to the procedure.  If this is needed, your child will likely wake up slower and have to spend additional time in the recovery area afterward.  For that reason, we like to avoid pre-op sedation if possible as children tend to be much happier if we can get them back home and in a familiar environment quicker.  The procedure takes only minutes so there is usually no need for an IV.  The anesthetist will monitor your child’s breathing and vital signs during and after the surgery.

    Is there any pain afterward?

    Occasionally we put tubes in older children and adults and when we do, they tell us that there is little to no discomfort afterward.

    Will my child need to use any medication after the surgery?

    If there is thick or infected fluid behind the eardrum when tubes are placed, your child may need to use some drops for a few days to help prevent the tube from becoming clogged.

    How long will the tubes last and will they have to be removed?

    Tubes usually stay for about a year and almost always come out on their own.  If they fail to come out after a couple of years, we recommend that they be removed.  It is very uncommon, though, to have to remove them.

    There are tubes that are designed to remain in the eardrum permanently.  These are used for patients who have had multiple sets of tubes and who obviously need a more permanent solution.

    In the past, patients with ear tubes could not get their ears wet.  Why has this changed?

    In the past, we assumed two things.  We assumed that swimming or bathing with tubes would allow water to get behind the eardrum.  We also assumed that allowing water to get behind the eardrum was something we needed to avoid.  As a result, we recommended water precautions.

    Recent studies, however, have disproven these assumptions.  We now know that it is very unlikely that water will pass through the tube under normal conditions.  And, if it does, there is no harm.

    Occasionally kids with tubes will experience some discomfort if water does pass through the tube.  These are the rare exceptions that may benefit from earplugs or water restrictions.

  • Post-Operative Instructions for Ear Tubes

    • Our office will call you to arrange for follow-up.
    • Not everyone needs ear drops afterward, but, if you are given drops, use them as labeled.
    • There is no need for water precautions. You can bathe and swim without restrictions.
    • There are no restrictions on diet or activity.
    • If you need to go to an Emergency Room, please use Crestwood Medical Center so Dr. Lockette can see you.
  • Clinical Practice Guideline: Otitis Media with Effusion

    (Click on Read More to access the Guideline publication)

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