Ear tube placement through the eardrum is a very common surgical procedure performed both in adults and kids. Ear tubes are placed in adults typically for chronic eustachian tube dysfunction while in kids, they are usually placed for chronic ear infections or hearing loss due to retained fluid.
Whether in kids or adults, sometimes this surgically placed tube can get clogged (as shown in the picture) preventing it from working properly. This would result in the recurrence of the same symptoms seen prior to tube placement.
Usually, the tube can get clogged from earwax buildup or secretions from the middle ear that dried up over the opening.
In adults, the clog can attempted to be manually removed using instruments under a binocular microscope. Given some amount of pain does occur with manual removal, distilled water drops are used instead with children with clogged ear tubes. The water hopefully slowly debrides the clog away. Ultimately, if the clog does not resolve, the tube can be replaced.
The above patient's clogged tube was successful unclogged manually as shown in the followup picture below. There is residual earwax debris around the tube which was left alone as removal was too uncomfortable for the patient. BUT... the tube at least was working again with a patent central opening.
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