What Is Ventilation Tube Placement in the Ear?
The Eustachian tubes, which open into both sides of the nasopharynx behind the nose, equalize the pressure in the middle ears with the external atmospheric pressure and provide ventilation of the middle ear. As a result of blockages in this canal caused by different reasons, the air in the middle ear is absorbed by the mucosa lining the middle ear and mastoid cells (air-containing cells in the ear bone), resulting in negative pressure in the middle ear. While a short-term dysfunction causes fluid in the tissues to accumulate in the middle ear cavity due to the negative pressure (serous otitis media), if the problem becomes chronic, the consistency of the accumulated fluid gradually thickens due to the increased secretory glands in the middle ear mucosa (secretory otitis media). At the same time, the eardrum being pulled toward the middle ear due to negative pressure may result in collapse of the membrane and, in the long term, adhesion of the membrane to the hearing ossicles in the middle ear and the floor of the middle ear (adhesive otitis).
Failure to correct this problem at an early stage may cause permanent hearing loss or serious middle ear infections, while conductive hearing loss that occurs from the serous otitis stage onward may also cause problems in speech and intellectual development, especially in growing children.
In patients in whom no positive improvement is detected in the negative pressure and fluid accumulation in the middle ear despite medical treatments given with appropriate content and duration, a hole is opened in the eardrum and a ventilation tube is applied in order to prevent negative air pressure in the middle ear, and it is necessary to bring the ventilation of the middle ear to the same level as the external ear canal.
Especially in chronic fluid accumulations lasting longer than 3 months and in cases where the consistency of the accumulated fluid is thick, a ventilation tube should be placed to provide ventilation for a sufficient period. Thanks to the simple procedure mentioned above, the collapse in the membrane is corrected (in ears where adhesion has not developed), and hearing loss rapidly returns to normal. In addition, removal of the adenoid has a positive effect on the long-term success of the treatment. Here, even if the adenoid is not large, it is routinely recommended to remove it while the patient is already under general anesthesia during tube placement because it disrupts circulation around the opening of the Eustachian tube.
Considering the season in which the surgery is performed and the characteristics of the patient, the ear, and the fluid accumulated in the middle ear, one of the tube types that either falls out spontaneously or remains on the eardrum until removed by the doctor may be preferred.
Ventilation tube placement in the eardrum is performed under general anesthesia in children. The tubes placed under a microscope with an approximately 10-minute operation (for tube placement in both ears) usually remain in the eardrum for 9-18 months and then fall out spontaneously or are removed by the doctor.
Late spring is generally preferred for removing a ventilation tube that has not fallen out after completing a total period of 18 months. After the tubes are removed, the holes in the eardrums close within 2-3 weeks. Since infections decrease during the summer period, the possibility of recurrence of the disease is reduced, while the elimination of the need to protect the patient’s ears improves quality of life. In patients whose timing coincides with the end of summer, it is recommended to wait until the following spring to remove the tubes.
With these treatments, the majority of patients recover completely, while repeated tube applications or permanent tube placement may rarely be necessary. Especially in children with recurrent ear fluid complaints, allergy and immune system functions should be evaluated. In patients whose Eustachian tube function does not improve, the tubes may need to remain in the ear for many years. Different tube types (T-tube) produced for such patients are available. In addition, the “Eustachian tube balloon dilation” method, which has become popular in recent years, is also recommended for resistant patients.
Children with tubes placed in the eardrum may swim in the sea in areas where the water is clean, provided that they do not dive. Especially in swimming pools and while showering or bathing with soapy water, they should enter the water after closing the external ear canal with petroleum jelly-coated cotton or a suitable earplug. In the event of infection and discharge due to water entering the ear, the condition can easily be brought under control with appropriate antibiotics administered orally and through the ear canal.
Frequently Asked Questions
What Is Ventilation Tube (Ear Tube) Placement?
Ventilation tube placement is a surgical procedure involving the placement of a small tube in the eardrum to drain fluid accumulated in the middle ear and provide ventilation of the ear.
In Which Cases Is a Ventilation Tube Inserted?
This procedure may be performed in cases such as recurrent middle ear infections, long-lasting fluid accumulation in the middle ear, hearing loss, and Eustachian tube dysfunction.
How Is Ventilation Tube Surgery Performed?
During the surgery, a small incision is made in the eardrum, the fluid in the middle ear is drained, and then a ventilation tube is placed to provide ventilation of the ear.
Is Ventilation Tube Placement a Painful Procedure?
The procedure is generally short and can mostly be performed under general anesthesia in children and under local anesthesia in adults when appropriate. Pain after surgery is generally mild.
How Long Does a Ventilation Tube Remain in the Ear?
Ventilation tubes generally remain in the ear for between 6 and 18 months and often fall out spontaneously. They may be removed by the doctor when necessary.
Does a Ventilation Tube Improve Hearing?
Yes, with the drainage of fluid accumulated in the middle ear, hearing improves significantly in many patients and the feeling of fullness in the ear decreases.
What Should Be Considered After Ventilation Tube Placement?
The doctor’s recommendations should be followed, follow-up examinations should not be neglected, and care should be taken to protect the ear from contact with water when deemed necessary.
Are There Risks Associated with Ventilation Tube Placement?
As with every surgical procedure, rare complications such as infection, early extrusion of the tube, formation of a permanent hole in the eardrum, or discharge may occur.
Is Ventilation Tube Placement Commonly Performed in Children?
Yes, ventilation tube placement is a commonly performed treatment method, especially in children who experience recurrent middle ear infections or long-term fluid accumulation in the middle ear.
Does the Eardrum Heal After the Ventilation Tube Is Removed?
In most patients, the eardrum heals spontaneously after the tube falls out or is removed. In rare cases, additional treatment or surgical intervention may be required.
