Eustachian tubes, which open behind the nose and on both sides of the nasal cavity, ensure that the pressure in the middle ears is equalized with the outside air pressure and provides ventilation. As a result of dysfunctions of the Eustachian canal caused by different reasons, negative pressure occurs in the middle ear as a result of the air in the middle ear being absorbed by the mucosa lining the middle ear and mastoid cells (air cells in the ear bone). While it causes accumulation in the middle ear cavity (serous otitis media), if the problem becomes chronic, the consistency of the accumulated fluid gradually thickens due to the increased mucus secretion glands in the middle ear mucosa (secretory otitis media). At the same time, the pulling of the eardrum towards the middle ear due to negative pressure may result in collapse of the membrane and adhesion of the membrane to the auditory ossicles in the middle ear and the middle ear base in the long term (Adhesive otitis).
Failure to recognize and correct these complications in time may result in permanent hearing loss. or serious middle ear infections, while conductive hearing loss that occurs from the stage of serous otitis has a negative impact on speech and mental development, especially in developing children.
Despite medical treatments given in the appropriate content and duration, negative pressure in the middle ear and In patients with no positive improvement in fluid accumulation, it is necessary to make a hole in the eardrum and allow air to come from the outside environment in order to prevent negative air pressure in the middle ear. These surgically opened holes usually heal and close within 7-10 days, and the problem recurs in cases where this period is not sufficient for the disease in the mucosa to heal.
Especially in cases of chronic fluid accumulation lasting more than 3 months and in cases where the consistency of the accumulated fluid is thick, the opening to the membrane is closed. It is necessary to prevent healing by placing a ventilation tube in the hole and to ensure adequate ventilation. Following this procedure, the collapse of the membrane is corrected (in ears without adhesion) and hearing loss quickly returns to normal.
Taking into account the season in which the surgery is performed, the characteristics of the patient, the ear and the fluid accumulated in the middle ear, One of the tube types that remain on the membrane until the eardrum is removed can be preferred.
A ventilation tube is applied to the eardrum for children under general anesthesia. The tubes, which are placed under a microscope in an approximately 10-minute surgery (only for tube application), generally remain in the eardrum for 6-12 months and then fall out on their own or are removed by the doctor.
After completing the 4-6 month period, the tubes that do not fall out are removed. The late spring periods are generally preferred for this. After the tubes are removed, the holes in the membranes close within 2-3 weeks. Due to the decrease in infections in the summer period, the likelihood of the disease recurring decreases, and the patient's quality of life is increased by the elimination of the need for ear protection. In patients whose 6-month period coincides with the end of summer, it may be preferable to wait until the next spring to remove the tubes.
With these treatments, the majority of patients recover fully, and rarely, repeated tube applications or permanent tube application may be required. Allergy and immune system functions should be evaluated, especially in children with recurrent serous otitis complaints. In patients whose eustachian function does not improve, the tubes may need to remain in the ear for many years. There are different types of tubes produced for this type of patients.
There is generally no harm in children with eardrum tubes placed in the sea in areas where the water is clean, as long as they do not dive. Especially in swimming pools and when taking a shower or bath with soapy water, the external ear canal should be closed with Vaseline cotton or a suitable ear plug to prevent water from entering the middle ear from the tube through the external ear canal.
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