How to Care for Your Child’s Ear Tubes
Ear tubes help protect your child from ear infections, middle-ear effusions (fluid behind the eardrum) and the hearing problems that go along with them. Most tubes last about 6 to 18 months, allowing many children time to outgrow their ear problems. Most tubes fall out by themselves. The change of a tube falling in, instead of out is very rare. Tubes that do not come out after three or more years may need to be removed by your doctor.
Possible Complications of Ear Tubes
Complications of ear tubes are usually minor. Some children develop a white mark or patch on the eardrum, which is called sclerosis. It does not affect your child’s hearing or future chance of ear infections. Some children develop a small depression or pocket in the eardrum at the tube site after it falls out. Again, this does not affect hearing and rarely requires treatment. About 1-2 out of every 100 children will develop a small hole (perforation) of the eardrum after the tube falls out. The hole will often close over time, but if it does not, it can be patched in the operating room.
Ear Tubes and Water Precautions
Wearing earplugs in the ear canal is not necessary after tube placement. Water does not usually go through the tube during swimming. Some children will wear earplugs when swimming because they feel more comfortable with plugs in that without.
Although most children with tubes do not need earplugs, they may be necessary in the following situations;
- Pain or discomfort when water enters the ear canal
- Discharge or drainage is observed coming out of the ear canal
- Frequent or prolonged episodes of ear discharge
Other times when earplugs may be needed on an individual basis are:
- Swimming more than six feet under water
- Swimming in lakes, rivers, ocean water, or non-chlorinated pools
- Dunking head in the bathtub
A variety of soft, fitted earplugs are available, if needed, as are special neoprene headbands to cover the ears. Never use Playdoh or silly putty as an earplug, because it can become trapped in the ear canal and require surgical removal. Alabama Nasal and Sinus Center Michael J. Sillers, M.D., F.A.C.S. Kristopher F. Lay, M. D.
Ear Tube Follow-up and Aftercare
Routine follow-up with your doctor every 4 to 6 months is important to make sure that your child’s tubes are in place and to check for any possible problems. All children need follow-up no matter how well they are doing. Children often feel well even when there is a problem with the tube. Once the tubes fall out, your child should return for a final re-check after 6-12 months so that your doctor can check the ears and be sure that fluid has not built up again.
Ear Tubes and Ear Infections
Your child may still get an ear infection with a tube. If an infection occurs, you will usually notice drainage or a bad smell from the ear canal.
If your child gets an ear infection with visible drainage or discharge from the ear canal:
- Do not worry; the drainage indicates that the tube is working to drain infection from the middle ear space. Most children do not have pain or fever with an infecton when the tube is in place and working.
- Ear drainage can be clear, cloudy, or even bloody. There is no danger to hearing.
- The best treatment is antibiotic ear drops alone. Place the drops in the ear canal two times a day for up to 10 days. “Pump” the flap of skin in front of the ear canal a few times after placing the drops. This will help the drops enter the ear tube.
- Ear drainage may build up or dry at the opening of the ear canal. Remove the drainage with a cotton-tipped swab dipped in hydrogen peroxide or warm water, a cotton ball to absorb drainage or gently suction with an infant nasal aspirator.
- Prevent water entry into the ear canal during bathing or hair washing by using a piece of cotton saturated with Vaseline to cover the opening; do not allow swimming until the drainage stops.
- To avoid yeast infections of the ear canal, do not use antibiotic eardrops frequently or more than 10 days at a time.
- Oral antibiotics are usually unnecessary for most ear infections with tubes unless you child is very ill, has another reason to be on an antibiotic, or the infection does not go away after using ear drops.
If your child gets an ear infection without visible drainage from the ear canal:
- Ask your primary care physician if the tube is open; if it is, the infection should resolve without a need for oral antibiotics or antibiotic ear drops.
- If your doctor give you an antibiotic or ear drop prescription anyway, ask if you can wait a few days before filling it; chances are high you will not need to medication. Use acetaminophen (Tylenol) or ibuprofen (Motrin) to relieve pain, if necessary, during the first few days.
- If the tube is not open, the ear infection is treated as if the tube was not there; the blocked tube does not do any harm (and will not cause a problem).
When to Call the Ear Doctor (Otolaryngologist)
Call the ear doctor if any of the following occur:
- Your child’s regular doctor cannot see the tube in the ear.
- Your child has hearing loss, continued ear infections or continued ear pain/discomfort
- Ear drainage continues for more than 7 days.
- Drainage from the ears occurs frequently
- There is excessive was build-up in the ear canal