Tympanostomy (Ear Tube) Procedure

This surgery is done by an ear, nose, and throat (ENT) doctor or otolaryngologist. During surgery, the doctor 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.

Making a slit

Once your child is asleep, the ear canal is cleaned. Then, using an operating microscope and special surgical instruments, the doctor 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 Using gentle suction, the fluid is withdrawn through the instrument.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 determine the cause of the fluid buildup, for example, what type of bacteria may be present.  

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

After the fluid is removed, the doctor 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 doctor 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 as follows:

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child of any age who has a repeated temperature of 104°F (40 °C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • Your child has had a seizure caused by the fever

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