Ear Infections - Surgery

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Complications. Otorrhea, drainage of secretion from the ear, is the most common complication after surgery and can be persistent in some children. It is usually treated with antibiotic eardrops. One study suggests that wearing earplugs may help the problem.

More serious complications from the operation are very uncommon, but may include:

• General anesthetic risks. Rarely, allergic reactions or other complications, such as throat spasm or obstruction, may occur. According to one 2002 study, such complications occur in less than 2% of the patients. The risk is highest in children who have other medical conditions, most commonly upper respiratory infections, lung disease, or GERD. Anesthetic-related risks are nearly always easily treated.
• Tube blockage. Sometimes the tubes become blocked from sticky secretions or clotted blood after the operation.
• Persistent eardrum perforation. This is the most common serious complication, but it too is rare.
• Scarring can also occur, particularly in children who require more than one procedure, but it almost never affects hearing.
• Small keratin (skin cell) containing cysts called cholesteatomas develop around the tube site in around 1% of patients.

Success Rates. Hearing is almost always restored following tympanostomy. Failure to achieve normal or near-normal hearing is usually due to complicated conditions, such as preexisting ear problems or persistent OME in children who have had previous multiple tympanostomies. In one 10-year study, hearing loss was still present in 12.5% of people who had had surgery, although in half of these individuals, hearing loss was very mild (loss was below 20 decibels). Persistent fluid was the main reason for continued impaired hearing. Only 1.9% of hearing loss cases could be attributed to complications of the operation itself.

A 2004 study randomized 429 children younger than age 3 to receive either immediate or delayed myringotomy with tympanostomy tube insertion (M&T). The children were subsequently evaluated at age 5 for signs of tympanic membrane damage, and also had their hearing evaluated when they were 6 years old. Among the findings: