Ear tubes are used for recurrent middle ear infections or for fluid in the middle ear that causes hearing loss (otitis media with effusion). A small tube is placed in the eardrum so that the middle ear can ventilate.

Why does fluid collect in the middle ear, and how long should we wait?

Fluid in the middle ear (otitis media with effusion) usually results from poor ventilation through the Eustachian tube: during upper respiratory infections, inflammation in the nose and throat spreads to the Eustachian tube and from there to the middle ear, causing fluid to build up. In children, enlarged adenoids are also an important factor, mechanically pressing on the Eustachian tube.

The good news is that in most cases the fluid clears up on its own, so for children who are not at risk a 3-month period of watchful waiting is recommended rather than starting treatment straight away. Hearing loss due to the fluid also usually improves on its own over time: in about half of cases within 3 months, and in most within 12 months. During this period, nasal steroid treatment can be helpful depending on the situation.

When the fluid lasts longer than 3 months, causes persistent hearing loss or affects the child’s speech and language development, the chance of it clearing on its own drops considerably, and ear tubes (together with adenoid surgery if needed) are considered.

How long does the procedure take, and is anaesthesia needed?

The procedure is short, about 5 to 10 minutes, and is done under a microscope. I use general anaesthesia for children and local anaesthesia for adults.

How long does the tube stay in, and does it fall out on its own?

How long the tube stays depends on its type. The type I use most often (the Paparella tube) usually falls out on its own within 6 months to 1 year, as the healing eardrum pushes it out. For patients who need ventilation for longer, I may choose a different tube (a T-tube) that can stay in for up to 5 years. We decide which type suits you or your child based on how long ventilation is needed.

Can you go in the water with ear tubes?

Yes, swimming is fine with ear tubes. Broad scientific evidence shows that surface swimming in a clean pool or the sea is safe, and that even routine use of earplugs does not meaningfully reduce the risk of discharge. The only thing to avoid is diving into deep water, because the increased water pressure raises the risk of water passing through the tube into the middle ear. The ear should also be kept away from water during the first month after the procedure or if there is active discharge from the ear.

Are ear tubes done together with adenoid surgery?

Often, yes. Especially when enlarged adenoids are one of the underlying causes of the fluid, we combine the two procedures in the same session rather than doing them separately. This is also the preferred approach because it spares the child a second anaesthetic.