What is Otitis Media?
Figure 1 Left acute otitis media.
Figure 2 Right otitis media with effusion.
Most cases of acute otitis media resolve without antibiotic treatment, but some require antibiotic treatment and analgesics. Rare cases can progress to more serious infections of the mastoid or brain. Serious otitis media can be observed for some time, but surgical drainage may be considered if there is a prolonged duration of hearing loss. Ventilation tubes (pressure equalization tubes) can be placed for cases of multiply recurrent acute otitis media or long duration of serious otitis media with hearing loss.
Figure 3 Left tympanic membrane with pressure equalization tube.
Myringotomy and Tube Placement
In adults, the ventilation tube can typically be placed in the office under local anesthesia. In kids, the procedure is performed as an outpatient surgery that takes a few minutes. The surgery is performed through the ear canal. Some children benefit from adenoidectomy if multiple sets of ventilation tubes have been needed in the past.
How the Surgery Works
The ventilation tube provides a secondary path of middle ear ventilation that helps the middle ear stay clear of retained fluids. It is the most effective method of keeping fluid from accumulating in the middle ear.
After Surgery Care
In many cases, antibiotic ear drops are used in the ear after surgery for a few days. Regular activities are started at any time. Patients remain at risk for ear infection related to water exposure, but these infections can typically be treated with antibiotic ear drops without the need for oral antibiotics. The tube usually comes out spontaneously within a year, but some tubes fail to come out in a timely fashion, in which case there may be an increased risk of a chronic tympanic membrane perforation.