About 20% of children up to the age of 6 receive eardrum tubes. This is one of the most common surgical procedures in children in the Netherlands. Below is an explanation of the how and why of these tubes and what actually affects children.
The ear
The ear consists of the ear canal, eardrum, the middle ear with the ossicles (hammer, anvil and stirrup) and the actual ear canal, the cochlea. Sound is a vibration. When this vibration enters your ear through the ear canal, the vibration is transmitted to the eardrum, amplifying it. The eardrum transmits the vibration via hammer, anvil and stapes to the cochlea, where the vibration is converted into nerve impulses. These nerve impulses travel via the auditory nerve to the brain and here these stimuli are translated so that you can hear them. The Eustachian tube also runs from the middle ear. This is a connection between the nasopharynx and the ear, and ensures that the pressure in the middle ear is the same as outside.
Why eardrum tubes?
In many young children the Eustachian tube does not work very well, it has not yet been really demonstrated how this is possible. The result is that the pressure in the middle ear is smaller than the pressure outside, causing the eardrum to be pulled inward. This creates a full, oppressive feeling. In addition, the middle ear can also become filled with fluid, because the mucous membrane in the ear becomes irritated and thus secretes too much fluid. This causes a lot of pain. Furthermore, children often cannot hear very well and their behavior changes, for example because they shout a lot or become very introverted. An eardrum tube is a small tube (1 mm to about 1 cm long) that is placed in the eardrum, so that there is actually a hole in the eardrum. This way, the pressure in the middle ear becomes the same as outside.
Operation and after?
The operation is often performed on an outpatient basis or as day surgery. Depending on the age of the child, local or general anesthesia is used. With general anesthesia, the child will have to fast. After any fluid in the middle ear has been removed, a small incision is made in the eardrum through which the tube passes. If the tube has been placed and everything is fine, the child can go home. You may experience a bit of a runny ear, but that usually goes away on its own. Swimming with tubes is allowed, but not too much under water. You can take a shower and the tube will come out automatically. Then the eardrum simply grows closed.