Tympanostomy (Ear Tube) Procedure

This surgery is done by an ear, nose, and throat (ENT) healthcare provider or otolaryngologist. During surgery, the healthcare provider removes the fluid from your child’s middle ear and places a tiny tube in the eardrum. This tube creates a very small tunnel between the outer ear canal and the middle ear. This tunnel balances air pressure on both sides of the eardrum and prevents fluid buildup. In most cases, surgery can be done on both ears in less than 30 minutes. In some children, the adenoids are also removed. The adenoids are small glands behind the nose and roof of the mouth. If adenoid problems are also being treated, surgery takes a little longer.

Cross section of child's ear showing fluid in middle ear and inflamed eustachian tube, acute otitis media (AOM).  Instrument is suctioning fluid from inner ear.

Cross section of child's ear showing fluid in middle ear and inflamed eustachian tube, acute otitis media (AOM). Tube is in eardrum.

Making a slit

Once your child is asleep, the ear canal is cleaned. Then, using an operating microscope and special surgical instruments, the healthcare provider makes a small slit in the eardrum (tympanotomy).

Removing any fluid

A hollow instrument is passed through the slit in the eardrum. Using gentle suction, the fluid is withdrawn through the instrument. A fluid sample may be sent to a lab to figure out the cause of the fluid buildup (for example, what type of bacteria may be present).  

Putting in the tube

After the fluid is removed, the healthcare provider inserts a tiny tube into the same slit in the eardrum (tympanostomy). The shape of the tube helps keep it in place. The ENT specialist chooses the right tube for the best results.

Right after surgery

After surgery is completed, your child will be taken to a recovery area. Once fully awake, your child should be able to go home.

When to seek medical care

Call the healthcare provider if:

  • Your child has bleeding from the ears

  • There is drainage from the ears after the first few days or increased drainage

  • Sticky or discolored fluid drains out of the ear after the first 48 hours

  • Your otherwise healthy child has a fever (see Fever and children, below)

  • Your child has had a seizure caused by the fever

  • You child is dizzy, confused, extremely drowsy, or has a change in mental state

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.