Ear Tubes (cont.)

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What are the general instructions and follow-up care?

An appointment for a follow-up ear check-up should be made 10 to 14 days after the procedure. At this visit, the position and function of the tubes will be assessed.

Usually, two different types of ear drops will be given to you the day of surgery. Cortisporin ear drops (or its generic equivalent) are to be used immediately after surgery for three days (3-4 drops each ear 3 times per day). If there is drainage from the ear after three days, continue to use the drops until the day before your office visit or as per doctor's instructions. Discontinue these drops if they cause severe pain or a skin rash develops.

You may substitute sulfacetamide/prednisolone (Vasocidin) drops if any of these problems develop. Vasocidin drops are used in the ear if water accidentally enters the ear canal. This will help prevent water contamination related ear drainage. Vasocidin drops are actually an eye medication, but are prescribed as a safe medication for the ears. Both drops should be warmed by holding them in the hand for five minutes and inserting into the ear canal along the side. You can "pump" them into the ear by pushing on the soft cartilage tissue located in front of the ear canal (medically termed the tragus).

Ear drainage may occur immediately after the procedure or at any time while the tubes are in place. Yellow clear fluid or mucous may drain for several days to weeks after the surgery. It is not unusual to see a bloody discharge following surgery. Cotton can be kept in the ear canal and changed as needed to keep dry. If after the immediate post operative period, profuse, foul-smelling discharge drains from the ear, an infection is the possible cause. If this occurs, begin by using ear drops for three days. If the drainage continues beyond three days, call the doctor to determine if additional medicine and/or an office visit is necessary.

Conventional medical advice is that water should not be allowed to enter the ear canal while the tubes are in place. Because there is now a passage into the middle ear to allow for ventilation, water can also pass into the middle ear space. If this occurs, ear drainage and infection may follow. However, there is some controversy as to whether this poses a significant risk, and many otolaryngologists disagree on the need for water protection. There is an increased risk of infection in lake or pond water, as opposed to chlorinated water found in swimming pools. Follow your doctor's advice regarding water precautions.

Your doctor may recommend utilizing ear plugs whenever there is a chance of water contamination (swimming, bathing, washing hair). Bathing caps or "ear bandits" are also helpful.

Tympanostomy tubes usually stay in place from 6 to 18 months. If they stay in longer than two to three years, they may need to be surgically removed. It is important to have an ear check-up about every six months during this time period. An audiogram is usually obtained at some point after the ear has healed. The tubes eventually fall out of the eardrum as the ear heals. Some children may have mild discomfort or bloody drainage at this time. The small hole in the eardrum at the old tube site usually heals within several weeks. Your doctor will instruct you when it is safe to allow water in the ears.

Previous contributing author and editor: Author: James K. Bredenkamp, MD, FACS
Editor: William C. Shiel, JR, MD, FACP, FACR

Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics

REFERENCES:

www.kidshealth.org, "Ear Infections."
www.entnet.org, "Ear Tube."
www.webmd.com, "Tubes for ear infections."


Medically Reviewed by a Doctor on 1/31/2014

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