Right ear: Acute otitis media	Left ear: Middle ear effusion	Right ear: myringotomy tube

Myringotomy Tube Insertion is an operation performed for some patients with chronic or recurrent otitis media.  This occurs in patients with Eustachian tube (auditory tube) dysfunction.  The Eustachian tube connects the middle ear to the back of the nose and maintains an air pocket behind the ear drum.  If this does not occur, ear infections can result.  A myringotomy or pin hole is made in the ear drum to allow fluid removal.  Air can now enter the middle ear through the ear drum, by-passing the Eustachian tube.  The myringotomy tube prevents the pin hole from closing over.  With the tubes in place, hearing should be normal and ear infections should be greatly reduced. 

After insertion of tubes pain should be mild, and plain Tylenol should be sufficient if medication is required for the first day or two.  In some cases your surgeon will prescribe ear drops after insertion of tubes.  Hearing is usually tested a few weeks after surgery. 

When tubes are in place, water can enter the middle ear through the tube introducing infection.  Ear plugs can be purchased at any drug store to prevent this when showering and washing.  If you prefer, we can supply custom molded ear plugs.  Swimming is safe with ear plugs, however diving below the surface should be avoided. 

An infection can occur with a tube in place.  This will generally result in drainage without pain or fever.  If you call the office immediately your surgeon can prescribe antibiotic ear drops.  Occasionally your surgeon will need to clean the drainage in the office and prescribe oral antibiotics. 

It is important to have the ears checked periodically by your surgeon as long as the tubes remain in place, and a schedule of follow-up visits every 3 to 6 months is appropriate. 

Most tubes will fall out of the ear drum in 9 to 12 months, although occasionally they may come out much sooner or later.  The ear drum should then heal by itself, and the tube will eventually fall out with the wax.  Many patients will not know when the tube has come out of the ear drum, and may not see it when it comes out with the wax.  Long-lasting (or 'permanent') tubes are used less frequently, and these can stay in place for years. 

The vast majority of patients do fine with tubes in place.  Rarely a patient will develop problems related to the tube requiring removal.  As this may occur with no symptoms, follow-up with your surgeon is very important.