It is applied due to the decrease in air pressure in the middle ear for various reasons and hearing loss caused by damage to the eardrum and auditory ossicles.

Middle Ear and Hearing Loss

The middle ear is the part of the ear that comes after the eardrum and before the inner ear. The space called the middle ear cavity is normally filled with air. With the decrease of this air pressure in the middle ear, fluid begins to accumulate in the middle ear cavity. This accumulated fluid prevents the auditory ossicles from moving, and this can cause hearing loss.

It is possible to prevent these situations that may occur in the middle ear by inserting an ear tube. A small ventilation tube attached to the eardrum can provide the air supply needed by the ear cavity and it can be ensured that the eardrum and ossicles regain their normal mobility. Conditions that require ear tube insertion may have different reasons.

What are the causes?

The middle ear is an area that has an important place for hearing functions of the body. The area in the ear after the eardrum and before the inner ear is the middle ear region. The middle ear cavity is an area filled with air. The amount of air in this area is in a balanced structure under normal conditions. However, under the influence of some factors, this air pressure in the middle ear region is damaged and decreases, a fluid begins to form in the middle ear cavity with the decreasing air pressure, and this fluid may prevent the movement of the auditory ossicles and cause hearing loss.

Ear tube surgeries are carried out in order to prevent hearing loss that may occur in the middle ear and to restore the normal functioning of the middle ear functions by regulating air pressure.

With ear tube surgeries performed under general anesthesia in children and local anesthesia in adults, 2 mm is inserted into the lower part of the eardrum. A small ventilation tube is attached. Through this ear tube, which is placed with one end in the middle ear and the other end in the outer ear, the fluid accumulated in the middle ear can be withdrawn, the air balance can be restored and the functions of the eardrum together with the auditory ossicles can be regained.

In which cases is a tube inserted into the eardrum?

• Aeration disorders in the middle ear;especially in aeration disorders caused by enlarged adenoids or large cleft palate.
• Persistent recurrent nasal/sinus inflammations;Sinus/nasal inflammations, which recur or have become the normal of our lives, cause the middle ear to not be able to get the air that it needs and also cause some problems.
• Nasal cavity tumors and tissue loss;The eardrum and auditory ossicles may be damaged as a result of the fact that this space opened to the ear by the Eustachian tube cannot provide the air needed by the middle ear as a result of tumor or tissue loss.
• Middle ear infections;These are conditions that cause excessive cambering of the eardrum and bring with it extreme pain. Middle ear infections that start suddenly (acute) and cannot be controlled with medication can cause serious damage to the middle ear. Effective treatment in middle ear infections will provide the air needed by the middle ear. Ventilation of the middle ear is of great importance in recurrent middle ear infections.
• The presence of a sticky fluid, such as gum, in the middle ear;affects the amount of air in the middle ear. These fluids are usually fluids that can heal on their own or with medical intervention, but in cases where the body cannot heal these fluids on its own or medical intervention does not work, they damage the middle ear.
• Barotraumas during flight or diving;both conditions mean that the middle ear is exposed to high pressure. This situation creates serious damage in the middle ear, which disrupts the air balance.
• Conditions where the Eustachian tube does not develop correctly;Diseases such as down syndrome and cleft palate prevent the eardrum or Eustachian tube from developing properly in patients, which damages the middle ear.
• Eardrum collapses;The eardrum is located just before the middle ear and the collapse that occurs at this point causes significant damage to the air balance.

How Is Ear Tube Surgery Performed?

Ear tube surgeries can be performed under general anesthesia (narcosis) in children and superficial (by contacting only the membrane area with a medicated cotton ball or by spraying the drug directly on the eardrum) or local (by injection) anesthesia in adults.

After anesthesia, the eardrum is drawn by entering the external ear canal under the microscope. The fluid in the middle ear is drawn out through this scratch, which is usually  placed on the lower part of the eardrum. If deemed necessary, a ventilation tube is placed at this point. The withdrawal of the accumulated fluid allows the auditory ossicles and eardrum to move again. A small ventilation tube of 2mm width, one end in the middle ear and the other end in the outer ear, is attached to the eardrum. With this small tube attached to the middle ear, it is ensured that the air balance is restored and the eardrum regains its ability to move together with the auditory ossicles.

In pediatric patients, adenoid, which has a significant effect on middle ear problems, is also removed by ear tube surgery.

With ear tube surgery, no externally observable change occurs in the patient’s ear.

Benefits of Ear Tube Surgery

With ear tube surgery, it is aimed to make a sensitive area such as the middle ear healthy, and the procedure is tried to be carried out in a way that maintains the same healthy functioning in the next process.

• With ear tube surgery, the risk of recurrence of otitis media is significantly reduced.
• With ear tube insertion, hearing loss caused by fluid accumulating in the middle ear is eliminated.
• With the elimination of the inflammation in the middle ear, the speech and balance problems caused by the inflammation are also eliminated.
• Sleep and behavior problems caused by otitis media are healed by ear tube surgery.

How long does the ear tube stay in the eardrum?

The duration of ear tubes inserted through ear tube surgeries varies according to the type of tube and the characteristics of the patient.

The tubes chosen for a patient who has an ear tube inserted for the first time are short-term tubes. These tubes stay in the ear for an average of 6-9 months and are then excreted by the body. If the tube cannot be removed by the body for more than 1 year, the tube is removed from the ear by giving the pediatric patients a light sniff of anesthetic gas.

In repetitive ear tube applications, long-term tubes (T-tubes) are used. Long-term ear tubes stay in the ear for more than 1 year, as long as the doctor prescribes. Long-term tubes that cannot be easily expelled by the body are removed by the doctor.

Life After Ear Tube Surgery

The ear should be protected from water from the moment the ear tube  is inserted. If the ear is protected but inflamed and drained, you should consult your doctor.