Tympanostomy
A tympanostomy is a surgical procedure during which a surgical opening is made in the eardrum, or tympanic membrane, in order to promote drainage of infected fluid from the middle ear and ear tubes are surgically implanted into the eardrum to promote ongoing drainage. After the tympanostomy, the tubes remain in place for several months.
Children who suffer from repeat ear infections often benefit from a tympanostomy since once the ear tubes are surgically inserted in the eardrum, air will able to circulate through the middle ear, allowing fluid to drain, preventing future buildup of fluid in the ear and restoring hearing. By decreasing pressure in the ears, the tympanostomy also serves to reduce pain. Most patients experience a significant reduction in the number of ear infections after this treatment, as well as relief from hearing loss and other troubling symptoms.
Reasons for a Tympanostomy
Middle ear infections, also known as otitis media, are a common childhood condition involving a buildup of excess fluid within the ear. This condition is most common in children between the ages of 4 months and 5 years. While most ear infections resolve on their own within a few days or are successfully treated with antibiotics, over-the-counter pain medication, decongestants or ear drops, some children may develop recurring ear infections that do not respond to treatment. Tympanostomy is usually considered when a child has fluid in both ears for more than 3 months or has repeated ear infections.
Ear infections and fluid in the ear may cause the following symptoms:
- Pain
- Fever
- Irritability
- Sleeping difficulty
- Hearing loss
- Behavioral problems
- Speech delay
In some cases the ear problems treated by ear tubes may be caused by structural malformation or damage to the ear. The doctor will decide whether or not to recommend surgery based on a thorough evaluation of the patient's age, specific medical problems and overall health. The tubes are usually effective in preventing ear infections and the buildup of pressure and fluid in the ears, but it is possible for these conditions to recur after the tubes are removed. If this occurs, the tympanostomy may have to be repeated.
The Tympanostomy Procedure
Tympanostomy involves a tiny incision in the eardrum, known as a myringotomy. Any fluid in the ear is suctioned through the created hole before the ear tube is inserted. The ear tube helps keep the hole open so that ongoing drainage can occur and the risk of ear infections is significantly reduced. This surgery is performed as an outpatient procedure under general anesthesia and only takes 10-15 minutes.
After surgery, patients will be monitored and discharged once the anesthesia wears off. Hearing loss and other symptoms are usually relieved immediately. There may be noticeable drainage from the ears for up to a week following the surgical procedure which is considered normal. Ear tubes usually remain in place for 6 to 12 months. Most tubes fall out of their own accord, but some tubes need to be removed by the doctor during a simple procedure.
Most children can return to school and other activities the day after ear tube surgery, but it is important for the ears to be kept clean and dry until the tubes come out in order to reduce the risk of infection. During the period that the ear tubes are in place, special care must be taken to keep water out of the ear canals during bathing. During swimming, the patient is usually required to wear earplugs. The doctor will assess when the eardrum has healed sufficiently for the patient to resume regular water activities.
Risks of Tympanostomy
Tympanostomy is a safe and effective treatment for recurring ear infections and carries only a low risk of complications. Some of the risks of ear tube placement may include:
- Infection
- Tearing of the eardrum
- Excessive bleeding
- Persistent drainage of fluid or pus
- Hearing loss due to thickened eardrum
All of these risks are considered rare and can be further reduced by choosing an experienced doctor to perform the procedure.
Recovery from Tympanostomy
As a result of ear tube surgery, the child's quality of life is usually greatly improved. After surgery, most patients see a significant decrease in ear infections, as well as improved hearing, speech, sleep patterns and even behavior patterns, since all of these factors may have resulted from painful ear infections and hearing impairment. Some patients may still get an occasional ear infection after surgery but this is considered normal.