What are the risks and benefits of getting myringotomy or ventilation tubes ("ear tubes")?

What do ear tubes do?

If fluid and debris cannot escape the middle ear through the natural Eustachian tubes, putting a tube through the ear drum lets the fluid drain out another way. (Read more about what causes ear infections here.)

When should a child get ear tubes?

Based on recommendations from both pediatricians and pediatric ear, nose, and throat specialists, we recommend considering ear tubes if a child has three separate ear infections in a six-month period, or four infections within one year. We also recommend tubes if there is a buildup of fluid in the middle ear (infected or not) for more than 3-4 months, because fluid buildup can cause hearing loss over the long term. There are other reasons why we will suggest tubes, such as certain kinds of speech problems, children with immune problems, and children with certain kinds of ear and face defects (like cleft lip or cleft palate).

What is the surgery like?

An ENT (ear, nose, and throat) surgeon makes a small incision in the ear drum and inserts a tiny plastic tube into the hole to keep it open. A child usually does not need deep anesthesia for the surgery, which usually takes only a few minutes. About one million children have tubes put in every year without problems. In fact, it's the most common surgery children have. If you have more specific questions about the procedure, ask the ENT surgeon where we refer you.

Will tubes cure ear infections completely?

Unfortunately, no. Ear tubes do mean the end of ear infections for many children, but other children still get ear infections after tubes. Also, tubes are designed to fall out between 6 and 12 months after they are put in. The tubes may work very well after they are put in, but the ear infections may return after the tubes fall out. (In this case, a second set of tubes may be needed.) In spite of all this, it is fair to say that, for most children, tubes dramatically cut down on ear infections.

What about preventive antibiotics instead of tubes?

For a long time, many pediatricians suggested prophylactic (preventive) daily antibiotics instead of ear tubes, which were seen as a last resort only if the preventive antibiotics failed. Some physicians will still occasionally recommend this. We don't recommend this any longer, however, for the following reasons:

  • The types of antibiotics we use for prevention usually don't work as expected.
  • The surgery is so simple and quick that there's really no need to avoid it.
  • Antibiotics, especially when used every day for months, have side effects, including diarrhea and yeast infections.
  • We are trying to use antibiotics sparingly, now that there are so many resistant bacteria.