Ear Tubes: What Are They?

Medically Reviewed by Zilpah Sheikh, MD on June 16, 2024
10 min read

Ear tubes are very small tubes that a doctor inserts in a person's ear to help drain fluid or pus. They are typically used to reduce ear infections in your child. Most children have at least one ear infection by the age of 5. But if they keep returning or if your child has hearing loss because of fluid buildup, ear tubes can provide relief for your child. They also prevent long-term hearing problems.

What do ear tubes look like?

Ear tubes -- also called tympanostomy tubes, ventilation tubes, myringotomy tubes, or pressure equalization tubes -- look like a small section of a tiny drinking straw. They’re round, hollow, and usually made of metal or plastic. Your doctor makes a small opening in the eardrum and puts in the tube to let air into the middle ear.

Your child will usually need ear tubes if they have a condition that causes inflammation or fluid buildup in the ear. Children who have a history of ear infections often need them, but they may also need ear tubes for other reasons. Your doctor might suggest tubes if your child gets:

  • Three or more ear infections in 6 months
  • Four or more ear infections in a year

Chronic ear infections

Ear infections are caused by viruses or bacteria collecting in the middle ear, the space right behind the eardrum. Children get more ear infections than adults because their eustachian tubes — which drain fluid — are smaller and almost level with the ground. Eustachian tubes may not drain as well, even in healthy children. 

When eustachian tubes swell or fill with mucus, like when your child has a cold, bacteria can thrive, leading to infection. For some children, this happens more often than for others. 

When an infection causes fluid buildup in the middle ear, it creates pressure and pain. Your child may also have the following symptoms when they have an ear infection:

  • Fluid draining from the ear
  • Sleeplessness or restlessness at night
  • More fussiness or crying than normal, especially when lying down
  • Seeming clumsy or having trouble with balance
  • Tugging at an ear

When to treat chronic ear infections

Your doctor might take a wait-and-see approach. Infections often go away on their own, especially if they are caused by a virus. Sometimes, your child needs antibiotics to kill infections caused by bacteria.

Some kids just get a lot of ear infections, and they don’t clear up very easily. Usually, it doesn’t cause long-term problems, but frequent ones can lead to:

  • Delays in learning, speech, and developing social skills
  • Hearing loss
  • Infection that spreads to other parts of the head
  • Tears, or holes, in the eardrum

Other reasons to get ear tubes

Your child may also need ear tubes for reasons other than recurring ear infections. Their doctor may recommend ear tubes if they have:

Otitis media with effusion. Fluid behind the eardrum when their ears don't drain well. Fluid may also stay there after an ear infection.

Chronic middle ear infections. These are long-term bacterial infections that antibiotics haven’t helped.

Chronic suppurative otitis media. These are persistent ear infections that cause tearing or a hole in the eardrum. Your child's doctor will put in an ear tube after they perform surgery to fix the tear.

There are two different kinds of ear tubes: short-term and long-term. The doctor will decide which to use based on things such as your child's age, how long their ear needs to be drained, and whether their eardrum has moved back toward their middle ear.

Short-term ear tubes are small and can stay in your child's ear for about 6 months to 2 years. They usually fall out on their own.

Long-term ear tubes have flanges that hold them in place. Although they can fall out, they usually stay in place for several years and may need to be removed by your child's doctor.

Adult ear tube surgery is usually only needed if you have a condition known as barotrauma. This happens when there is a major change in pressure in the air (such as on a plane) or in the water (such as when scuba diving). Symptoms -- which include ear pain, dizziness, and nausea -- often go away without medical treatment. If they don't, your doctor may recommend ear tubes to keep fluid from building up in your middle ear.

Ears have natural ventilation through your eustachian tubes -- narrow tubes that run from your middle ear to high in the back of your throat. The side of the tube in your throat opens and closes to:

  • Stabilize air pressure
  • Refresh the air in your ear
  • Drain fluid

When swelling or mucus keeps natural ventilation from working, ear tubes act as a small window for your ear. They provide an alternative way to help air flow into and out of the ear, which keeps pressure even and helps the ear drain better. With better airflow, fluid won’t build up and bacteria won’t have such a friendly home.

Before your child’s ear tube surgery (also known as tympanostomy), you will likely get instructions from the hospital. Children who need to be given something to sleep will have to fast, or go without eating, for a certain number of hours before the surgery. Your child won’t be able to eat anything and can drink only certain liquids.

Check with your doctor to make sure you know:

  • How long your child has to fast
  • Which liquids are OK to take
  • If your child can take any medicine before surgery

Your doctor will want to know about:

  • Medication your child takes
  • Problems that your child, or anyone in your family, has with drugs used for anesthesia (which make you unconscious, so you won’t feel pain)
  • Your child’s drug allergies

For adults getting ear tubes, your doctor may have similar questions.

Children, like some adults, will have concerns about what’s happening. To help them get ready for surgery, you may want to:

  • Ask questions so they can talk about their feelings, and you can make sure they're not confused about anything.
  • Be specific about how the surgery will help, such as, “Your ear will feel so much better.”
  • Talk ahead of time about going to the hospital. A good general rule is to talk 2 days ahead of time for a 2-year-old, 3 days for a 3-year-old, and so on.
  • Let them pick a toy or blanket to take to the hospital.
  • Remind them you’ll be there the whole time.

As you talk with children, it’s best to avoid certain phrases. If you say, “put you to sleep,” that may remind them of a pet that’s been put down. Instead, you could talk about how a special doctor has medicine to help them sleep well. The words “cut” or “make a hole” may make a child think of pain. Instead, you can say “make a small opening.”

On the day of surgery, you’ll take your child to a hospital or outpatient surgery center. The doctor may give your child medicine to sleep through the procedure. The main reason they do this is to make sure your child doesn’t move during surgery. Doctors will keep a close eye on your child's heart rate, oxygen, and blood pressure to make sure everything’s going well. Older children and adults can have the surgery while they’re awake. For them, it can be done in the doctor’s office.

How long does ear tube surgery take?

Ear tube surgery takes about 15 minutes. During it, the surgeon:

  • Makes a tiny cut in the eardrum with a scalpel or laser
  • Removes fluids from the middle ear with suction
  • Puts the tube into the hole in the eardrum

After it’s over, your child will go to a recovery room where nurses and doctors ensure that there were no problems. If all is well, you should be able to take your child home within a few hours.

If your child has hearing loss from fluid buildup, it goes away as soon as the tubes are in. For delays in development, you’ll likely see improvement in the weeks and months ahead.

If your child was given anesthesia, it may take them a little while to fully wake up. Your child may also be groggy and possibly nauseated for the rest of the day. They should be back to normal after 24 hours. Anesthesia can also make your child run a fever for up to 72 hours after surgery. If their fever is higher than 102 F, call the doctor. Your child can go home right away if they weren’t given any anesthesia. The same is true for adults who get tubes. Your child may have a little bit of pain after surgery, but most patients don't.

Your doctor will talk to you about the next steps. 

Follow-up visit. Your child will have a follow-up appointment with their ear doctor in 2-4 weeks. They may also have follow-ups with their primary care doctor 4-6 months later.

Hearing test. If your child had hearing issues, your doctor may recommend a future visit for a hearing test.

Ear drops. Your doctor may give your child ear drops to limit fluid coming from the ears and reduce the chance of infection. If they do, make sure to use all you are given, even if your child doesn't have symptoms of an infection. After using the drops, press on the cartilage at the front of the ear to help the drops get to the right place inside the ear. If their drainage is really thick, you can put a little hydrogen peroxide in first.

Once the tubes are out, the opening in the eardrum usually closes on its own. If it doesn’t, your doctor may do a procedure to fix it.

Ear tube drainage

For about a week after surgery, you may see fluid that has a small amount of blood or mucous draining from your child's ear. This is usually the fluid that built up before surgery. If you see yellow, brown, or bloody fluid from the ear for more than a week after surgery, tell your doctor.

Ear tube surgery is a safe procedure and doesn’t pose much serious risk. However, your child could have:

  • Bleeding or infection
  • Scars or weakness in the eardrum
  • Tubes that fall out
  • Drainage of ear fluid that doesn’t stop
  • Blockages in the tubes from blood or mucus
  • Eardrums that don’t close after tubes are removed
  • Shrinking or hardening of the eardrum

Some children have problems after being under anesthesia and may have:

  • An allergic reaction
  • Trouble breathing
  • Heart irregularities
  • Nausea or vomiting

After an ear tube operation, talk to your doctor if your child has unusual fluid coming from their ear for more than a week. You’ll also want to check with them if your child has ear pain, hearing problems, or trouble with balance. 

Putting in ear tubes is a safe procedure, but your child may have some complications afterward. These can include:

Repeated ear infections. Your child may still have ear infections even with tubes in their ear. These usually clear up quickly, because the tubes allow for drainage. They usually don't require antibiotics given by mouth, but their doctor may prescribe antibiotic ear drops.

Fear of noises. Your child may have had some hearing loss if their ears have been filled with a lot of fluid. Now that the fluid is gone, they may be scared of some loud noises such as dogs barking or the vacuum cleaner. It just means that your child's hearing is back to normal, and they should be used to the sounds in a couple of weeks.

Ear tubes fall out. If the ear tubes fall out too quickly, your child may need another surgery to put in new tubes.

Blocked tubes. Ear tubes can get blocked by blood or fluid that turns solid. If this happens, they will need to be cleaned or replaced.

The positive benefits of getting ear tubes include:

  • Fewer or no ear infections
  • If your child still has ear infections, they will be milder
  • Better hearing
  • Improved speech
  • Better behavior, if pain from ear infections was causing your child to be fussy or irritable
  • Less need for repeated use of antibiotics for ear infections
  • Better balance and coordination
  • Better sleep, if ear infections make it hard for them to sleep

Ear tubes and swimming

Swimming, bathing, and taking showers are generally OK after ear tube surgery. If your child dives a lot in the deep end of pools, your doctor may recommend ear plugs (it takes 2 feet of water pressure for water to get into an ear tube). If your child will be swimming in a lake, river, or other water that may have more bacteria, your doctor may suggest using earplugs.

When the ear heals after surgery, it should cause the tube to slide out of your child's ear. Ear tubes are so small that your child probably won't notice when they fall out. If the tube begins to fall out but gets stuck, your child may have drainage and an itchy ear. If this happens, call your doctor and they can remove the tube.

If your child has repeated ear infections or has some loss of hearing because of fluid in their ears, they may need ear tubes. This is generally a simple procedure, and only small children need anesthesia for it (to keep them from moving during surgery). Ear tubes usually stay in for several months and fall out on their own.

How many ear infections do people get before getting tubes?

Three or more within 6 months or four in 1 year. Children may also need ear tubes if there is a lot of fluid in their ears, even if they don't have many infections.

How painful is getting tubes in your ears?

Surgery for ear tubes is a quick, 15-minute procedure. There is usually very little pain, if any, after surgery.