The ear is composed of 3 separate spaces, the outer ear (ear canal) the middle ear and the inner ear. The outer and middle ear can both become exposed to bacteria and can become infected. Outer ear infections (swimmers ear) are caused by bacteria growing in the ear canal, often trapped there in contaminated water. Symptoms include severe pain, pain when you touch your ear, and in extreme cases swelling of the ear itself. Outer ear infections (otitis externa) are typically treated with ear drops, and occasionally with antibiotics by mouth.
The middle ear is an air filled space behind the eardrum that contains the 3 tiny bones of hearing. The Eustachian tube connects this space to the back of your throat and allows you to equalize the air pressure. If the Eustachian tube is blocked or malfunctioning, the middle ear space can fill with fluid and become infected. This is called otitis media. The infection from otitis media usually responds to antibiotics. However, the fluid can persist in the middle ear for up to one month after an infection. This can cause temporary hearing loss, and occasionally recurrent infections.
Tympanostomy tubes are a surgical procedure which relieves the buildup of fluid in the middle ear. Typically it is performed either for persistent fluid that is causing hearing loss, or for recurrent infections. In adults, it may be performed in the office with numbing medicine or in the OR with IV sedation. Children require general anesthesia. The procedure takes only 5 minutes. Your surgeon will make a small incision in your eardrum to allow the fluid to drain, and then place a tube in the incision to keep it open. You will be given prescription for drops to prevent infection.
There is very little discomfort after the procedure. Some minor bleeding or drainage from the ear afterwards is common. You will need to keep water out of your ears for 2 weeks after the procedure by wearing earplugs or cotton coated with Vaseline when showering. After that, you only need to wear earplugs with extensive swimming or diving. You will need to follow up every few months until the tubes fall out which typically occurs within 6 to 18 months.