Pressure Equalization Tubes (Ear Tubes)

Tympanostomy involves the placement of Pressure Equalization Tubes (PET) into the eardrum to allow fluid and pressure to escape into the ear canal. When the patient is under general anesthesia, an operating microscope is used to look in the ear canal, a small incision is placed in the eardrum, any fluid is suctioned out and the PET is placed into the hole. After PET placement, a patient’s hearing is immediately restored, and the aeration of the middle ear reduces the likelihood of recurring cases of otitis media. If infections do occur, they are more easily detected since they cause ear drainage. They are also less painful and may be managed with eardrops alone instead of oral antibiotics.

The actual surgery only takes about 15 minutes with no additional time off required. Recovery time is typically minimal with little pain.

For most patients, Pressure Equalization Tubes last an average duration between 6-24 months, the usually come out on their own as the growing eardrum rejects the tube. Smaller tubes generally stay in a shorter period of time (6 months), while tubes with larger inner flanges stay in longer (2-3 years).

PET placement is common, simple and a safe procedure that rarely result in serious complications; however, some complications may occur, including:

Early extrusion: Occasionally, tubes may come out earlier than expected, and may have to be replaced.

Persistent drainage: If future infection does occur, fluid will drain since the tube allows the infection to escape out of the ear. If this occurs, the patient will require antibiotic eardrops instead of oral antibiotics.

Eardrum Perforation: Once the PET comes out, some eardrums may not close or heal completely. If this occurs, a second minor procedure may be required to close the hole.

Persistent PET: Uncommonly, a PET may persist in the eardrum for years. In this case, the tube may be surgically removed.

Hearing Loss: PET may damage hearing in the middle ear, though it is extremely rare, and surgical repair of the hearing bones may be required.

Tympanosclerosis: Tympanosclerosis is scarring of the eardrum, but this typically has no clinical or hearing significance for most patients.

Risk from Anesthesia: Although extremely rare, complications may occur from the medicines and the anesthesia procedure.

One of the many benefits of PETs is that, once placed in the eardrum, they require little maintenance. For a few days after the procedure you may be instructed to use eardrops or to keep your ear dry (use ear plugs) at all times. Most PETs patients should refrain from diving deeper underwater or swimming in lakes and rivers, which is more likely to cause infections.

Patients must follow-up every 3-6 months to have ears examined to ensure the tube is still functional.

Another advantage of PETs is that patients no longer have to “pop” their ears in-flight, because pressure cannot build up behind the eardrum.

General ENT

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