Ventilation Tubes in adults

• Ear pain
• Blocked ear
• Hearing loss
• Tinnitus
• Popping
• Middle ear fluid
• Occasional ear infection

  Rarely a person will have more long-lasting, more serious complications from eustachian tube dysfunction

• A chronic ear drum perforation (with unsuccessful repairs)
• Scarred, retracted ear drums
• cholesteatoma
• mastoiditis

          a weak, retracted area at 11 o'clock & yellowish middle ear fluid

            ear drum scarring                    ear drum perforation

Causes

• unlucky anatomy (specifically a poorly working eustachian tube)
• an allergy 
• a cold (virus)
• rapid changes in ambient pressure (such as when flying in an airplane)
• something blocking the eustachian tube opening in the back of the nose

Timely treatment of eustachian tube dysfunction can prevent symptoms, but also protect ear drums from chronic scarring, perforations, mastoiditis and cholesteatomas.
 

Treatment

• Valsalva maneuver (hold your nose and blow): useful for temporary relief
• Oral and topical decongestants (not very effective)
• Topical nasal steroid sprays (not very effective)
• Antihistamines (not very effective)
• Oral steroids (e.g. Prednisone) - usually the best medicine to try.
• Myringotomy and often the addition of a ventilation tube.   

In adults, the big advantage is that the procedure can be performed in the office with the help of a microscope. The eardrum can be numbed, a tiny incision made, possibly the middle ear cleaned of fluid and, if needed, a ventilation tube is placed. The entire procedure usually lasts only a few minutes. Often a different style ventilation tube (called a T-tube because of its shape- pictured above) is used because it is designed to last 2 or 3 years before the eardrum can push it out and it can be easily removed at any time. The risks include mild discomfort, a few minutes of dizziness, an echoing sound and a persistent ear drum perforation.  Another consideration is that one needs to protect the ear from water in the presence of a ventilation tube.  While water precautions are more variable for washing, swimming usually requires an ear plug and is best secured with some type of swimming cap or neoprene head band, such as an EarBandit (EarBandit.com)  or Surf Muff (SurfMuff.com)   Customized ear plugs which fit tightly and comfortably.  Also, if they fall out, they are colorful and will float.

“For many years I suffered with ear infections at least twice a year. Finally, at the age of 49, I had tubes put in my ears and have had only one infection in 3 years.”      - Michael Poccia

Tips on Flying

• Try an oral decongestant, such as Sudafed. Or a combination of antihistamine and decongestant, such as nonprescription Actifed or prescription Allegra-D (12 or 24 hour). Or, better, try a topical nasal decongestant, such as Afrin or Neo-Synephrine. Decongestants can make one feel racy and should not be used by people with certain medical problems, such as high blood pressure, heart, thyroid or kidney disease. Those with a history of sinus disease or nasal congestion may want to use a topical nasal steroid spray, such as Flonase, Nasacort, Nasonex, or Rhinocort, for the week before flying.
• If you have allergies, take an antihistamine, such as Benedryl, Chlortrimeton, or Dimetapp (none of these require a prescription) or Allegra, Clarinex, Zyrtec or others that require a prescription. The prescription antihistamines are supposed to cause less drowsiness, but are no more effective. All of these medicines may bring on sleepiness and cannot be combined with alcohol.

• Sip on a drink.
• Chew gum or swallow over and over again.
• A child might be encouraged to blow up a balloon.
• Keep your mouth closed and pinch your nose while blowing out.
• Some have found success with the specialized ear plugs EAR PLANES which are essentially ear plugs. Available in pharmacies.
• Those with a ventilation tube in their ears should have no trouble with ear pain.