Sometimes physicians will treat a child with an antibiotic to speed up the removal of the fluid. If the fluid persists for more than three months and is associated with a loss of hearing, many physicians recommend "tubes" be placed in the affected ear or ears for
ear infection treatment. This surgery, called a myringotomy, can usually be done on an outpatient basis, by a surgeon who is usually an otolaryngologist (a physician who specializes in the ears, nose, and throat).
While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum. A small metal or plastic tube is placed into the opening in the eardrum. The tube ventilates the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment. The tube normally stays in the eardrum for 6 to 12 months, after which time it usually falls out on its own. In rare cases, a child may need to have a myringotomy more than once.
If a child has enlarged or infected adenoids, the surgeon may recommend removal of the adenoids at the same time the ear tubes are inserted. Removal of the adenoids has been shown to reduce episodes of otitis media in some children, but not those who are under four years of age. Research, however, has shown that removal of a child's tonsils does not reduce occurrences of otitis media. Tonsillectomy and adenoidectomy may be appropriate for reasons other than middle ear fluid.
Hearing should be fully restored once the fluid is removed. Some children may need to have the operation again if the otitis media returns after the tubes come out. While the tubes are in place, water should be kept out of the ears. Many physicians recommend that a child with tubes wear special ear plugs while swimming or bathing so that water does not enter the middle ear.
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