Dr. Anton Milo, director of Akron Children’s Hospital’s ENT Center, answers the most-asked questions from parents about ear tubes. What happens when ear tubes fall out or move? When should they fall out? What if there is mucus, blood or other drainage and leakage issues? See below for the answers to these questions and more.
Ear tubes falling out or moving
• Is it ok when a tube falls out of the ear?
Yes, that’s normal. Most tubes fall out on their own within 6 to 12 months.
• What causes ear tubes to fall out?
The ear’s natural healing process causes the tube to fall out. As the ear heals, it tries to close the hole made by the tube. It squeezes that tube out and it falls out of the ear drum. Rarely does the pediatrician have to go in and take the tube out. They fall out 90 percent of the time within two years.
• How can I tell when the ear tubes have fallen out?
A lot of times a parent can’t tell when the ear tube falls out because it can get stuck in a little bit of wax in the ear canal. That’s why the pediatrician checks the child’s ears every four months until the tube falls out. Sometimes the pediatrician will see it sitting in wax in the ear canal and cleans it out in the office.
• What happens if the tubes in the ear move?
It does move as it extrudes, but a patient can’t feel it. The tube is placed in the front of the ear drum (anterior). As the ear heals, it rotates that tube around to the back edge and it tips and falls away.
• What do I do when the ear tubes fall out?
Eighty percent of patients will improve with a set of tubes. There’s no way to predict what child will have re-occurring ear infections. If a child needs a second set of tubes, most likely your pediatrician will recommend taking the adenoids out. That gives the child a higher chance of curing his/her ear infections.
• What if an ear tube is lying in the ear canal?
No big deal. That’s usually where it is found, and then gets cleaned out by your pediatrician. Patients can’t tell it’s there; it’s like having wax in your ear, basically.
• What happens if my child’s ear tubes fall in the ear rather than in the canal?
That’s called a tube that intrudes, not extrudes. It depends on where it is and whether it’s bothering the child. If it’s not bothering the child, you don’t have to do anything. It’s sterile in there and it won’t harm the child. However, it can be surgically removed.
Water and ear tubes
• Can you get water in your ears once your tubes have fallen out?
Patients can get their ears wet as long as the ear has healed. Sometimes there are cases where the tubes extrude and the ear drum doesn’t heal, so there’s a hole or perforation. It is the ear’s way of staying healthy. Air ventilates through that tiny hole where the tube used to be. The pediatrician will watch it and treat it as if it were a tube. It must be kept dry. A lot of times it will close up eventually.
General ear tube questions
Ear Tubes – Leaking, mucus, blood, and drainage
• How does the mucus drain from my ears?
A patient really shouldn’t have mucus. Instead, they should have air flowing in the ear. If there’s mucus, it’s a sign of lack of ventilation in the middle ear. That’s how ear infections/problems develop in kids.
• Why is blood coming from the ear with ear tubes?
Usually, it’s a sign of an infection. Infections can be bloody, pussy or emit clear drainage that looks almost waxy. Ear drops can treat the infection.
• When ear tubes fall out, is fluid drainage normal?
When Eustachian tubes have a chance to grow and mature, ears ventilate and stay healthy with air. If there’s fluid, it’s a sign of lack of ventilation in the middle ear. That’s how ear infections/problems develop in kids.
• Is it normal for kids with ear tubes to leak fluid?
Yes, it is normal in a sense. Initially, children can get fluid draining out of their ears because during surgery, when doctors suction out the ears to put the tubes in, they can’t get all the fluid out. It may drain for a day or two after surgery, and that’s why children must use ear drops afterwards.
General Ear Questions
• Can giving repeated antibiotics for a child’s ear infections make it worse?
No. But, it can cause the child to develop an allergy to something or it can create resistant bacteria, and that makes it more challenging to treat.
• What happens if we don’t give children antibiotics for bacterial ear infection?
It will get worse and the child can develop potential complications, such as mastoiditis or other problems. If a child has an infection, it should definitely be treated.
• How do you eliminate fluid in the middle ear of an infant?
Medicine or ear tubes can eliminate it. Tubes are inserted when children fail medical therapy. The American Academy of Pediatrics printed guidelines for referring children for the evaluation of ear tubes. When a child experiences many infections, a parent should consider ear tubes.
Also, kids who have a family history of Eustachian tube troubles, attend daycare frequently or live in homes with smokers have a six to seven times higher incidence of ear trouble.
• What causes ear infections?
Ear infections occur when fluid gets trapped in the middle ear. If an ear can’t ventilate the space due to Eustachian tube dysfunction, fluid can develop and get infected, either virally or bacterially.
• Is a ruptured eardrum from injury different than from cotton swabs?
Cotton swabs should never be put in an ear, especially in a child’s ear. The swab can actually push more wax/debris in the ear than what it takes out. It can rupture the ear drum and actually cause permanent hearing loss.
• How long does it take for swimmer’s ear to clear up?
It depends on how severe it is. Typically, the pediatrician can clean it out that first day and cure it with ear drops. An infection in the ear canal causes skin and debris to build up. That must be cleaned out. Otherwise, it doesn’t get better. Depending on how severe it is, the pediatrician may have to clean it out every couple days and treat the child with ear drops. Also, it’s important to keep the ears dry so they can heal.
• How do I keep my child’s ears clean?
In most young children, the wax works its way to the ear opening. Clean that in the bath/shower or wipe it away with a tissue. Cotton swabs should never be put in an ear, especially in a child’s ear.