About Ear Tube Surgery

10 Facts On Ear Tube Surgery

Glue ear is the layman’s term for otitis media with effusion (OME).
Glue ear happens when fluid is trapped in the middle ear space behind the ear drum, and does not drain through the eustachian tube which connects the middle ear and the back of the nose.
In children, the majority of the ear tube surgery is in those below 6 years old, due to immature eustachian tubes. It is a WHO identified cause of concern for hearing loss.
Glue ear has a higher prevalence where there is higher crowding (including day care centres), infectious disease, allergy, large adenoid, malnutrition or craniofacial differences.
In adults, ear tube surgery is needed for glue ears aggravated by sinusitis, allergy, head and neck cancer, dive and flight middle ear pressure issues; and the need to place ear tubes to instil middle ear medications to treat hearing loss and giddiness, or for hyperbaric oxygen therapy that treats burns, infections and diabetic wounds that are hard to heal.

Chronic glue ear results in hearing difficulties, speech, language and academic delays. It reduces quality of life, social and work options longer term. It increases caregiver burden.
Serious effects include permanent hearing loss, brain infection, ear bone erosion and ear tumor.
Ventilation ear tubes (a.k.a Tympanostomy or Grommet tubes) are inserted to drain chronic middle ear fluid or prevent repeated acute otitis media.
During surgery, an incision is made on the ear drum, and a ventilation ear tube is inserted onto a less than paper-thin ear drum through a small ear canal 0.4 - 1 cm in diameter (child - adult).
Current surgery usually requires a change of multiple instruments, general anesthesia, operating theatre setting and a costly surgical microscope, especially so for children.

Prevalence rates of otitis media is high, reaching 15% in USA, 25% in India to even 50% amongst the Aborigine population in Australia. Even in USA, only 15% of those told by their doctors to get ear tubes agree to or can access the surgery.
Similar numbers of children and adults get ear tubes a year in USA, as there are many more adults than children.
Otitis media is the leading cause for children visits to doctors.
Otitis media is the leading cause of antibiotic prescription by doctors for children.
Otitis media is the leading cause of hearing loss in children.

Ventilation tube insertion is the most common surgery performed under general anesthesia for children.
In children, the peak prevalence of otitis media occurs between age 6-18 months and 4-5 years.
80% - 90% of children in USA have at least one documented middle ear effusion by age 2 years.
One third of children in USA experience six or more episodes of acute otitis media by age 7 years.
The reported number of ventilation tubes placed worldwide are underestimations of the real need – challenges with access, cost, general anesthesia and surgical microscopes.