What to Look for When Ear Tubes Fall Out - Pictures, Care Tips, and Follow Up

What To Expect When Ear Tubes Fall Out

Ear tubes, also known as tympanostomy tubes or grommets, are tiny cylinders surgically implanted in the eardrum to treat chronic ear infections or fluid build-up. Ear tubes are designed to fall out on their own once the infection clears. When this happens, the eardrum usually heals normally.

This guide covers what to look for when ear tubes fall out, what to expect, and key next steps for care and follow-up.

Ear Tube Basics

Ear tubes involve a minor surgical procedure to insert a small tube through the eardrum. This serves to ventilate the middle ear and equalize pressure.

The tubes typically fall out on their own within 6 to 18 months as the eardrum slowly pushes them out. This allows the eardrum opening to close over. In most children, the ears then function normally.

Ear tubes help resolve chronic ear issues, but their purpose is temporary. Doctors monitor ear health as the tubes eventually come out in the natural course of healing.

Appearance When Ear Tubes Fall Out

When your ear tubes fall out, you may notice some drainage on your pillow in the morning. This is from fluid trapped behind the tube exiting the ear.

You may also see the actual ear tube, which is roughly 2-3mm long, like a small plastic or metal cylinder. In some cases, the tube falls out without being noticed.

Looking at the ear with an otoscope allows a doctor to confirm the tube came out by the appearance of the eardrum. There will be a small hole where the tube was previously seated.

The hole usually starts to heal closed within a few weeks after tube extrusion. A ring of scar tissue forms as the outer eardrum layer mends.

Pain When Ear Tubes Fall Out

Fortunately, there is not usually much pain associated with ear tubes coming out. The tubes are designed specifically to prevent trauma or tearing of the eardrum when they exit.

Having an ear tube come out does not typically cause severe ear pain. Mild discomfort, popping sensations, or pressure may be noticed. Drainage of residual fluid creates a wet feeling.

Sharp pain, bleeding, ringing in the ear, spinning sensations, or hearing changes warrant medical evaluation after a tube comes out. This may signal a complication like a residual hole or infection.

Bleeding When Ear Tubes Fall Out

A small amount of spotting on the pillow is normal when an ear tube falls out overnight. However, any significant bleeding is abnormal and should be evaluated urgently.

While unlikely, more severe bleeding could indicate:

• Trauma to the eardrum
• Tube became embedded or stuck
• Infection
• Hole or perforation in the eardrum

Minor blood-tinged drainage often resolves quickly. But recurrent or heavy bleeding when a tube extrudes requires medical treatment to prevent complications.

Pictures of Recently Extruded Ear Tubes

Here are some pictures to give an idea of how the eardrum and ear canal may appear when ear tubes first fall out:

These images show the small tube exiting site and residual hole before healing occurs. Drainage, redness, and scar tissue formation are also visible.

How Long Does the Hole Take to Close?

In most cases, the small hole left behind after an ear tube falls out begins to close within 1-2 weeks. Complete closure typically occurs within 4-8 weeks.

During this time, the outer eardrum layer migrates to cover the perforation. A ring of scar tissue forms around the closure site.

Rarely, a residual hole may remain, requiring additional treatments. But for most children, the eardrum heals fully on its own within 1-2 months.

Can Ear Tubes Fall Out Too Early?

Ear tubes are designed to spontaneously extrude once their purpose has been served. However, occasionally tubes do fall out earlier than intended.

Early tube loss is more likely if:

• The tube gets dislodged due to injury or trauma to the ear
• The tube migrates internally farther into the middle ear space
• Pressure changes forcefully push out the tube
• An unsecured tube style was used

Early extrusion may result in recurrence of fluid accumulation or infection if the underlying problem is not yet resolved. A replacement tube may be recommended if this occurs.

Ear Tube Doesn't Fall Out

While ear tubes are expected to spontaneously come out within 6 to 18 months, occasionally a tube does not fall out as predicted.

A tube that stays in longer than anticipated is more likely if:

• Thick, sticky fluid remains trapped behind the tube
• Scarring has built up around the tube
• The tube has become embedded in the eardrum tissue

If a tube fails to extrude after 2 years, your doctor may recommend removal to prevent permanent perforation of the eardrum. This involves a simple office procedure.

Caring For Your Child When Ear Tubes Fall Out

When notified that your childs ear tubes have fallen out, discuss next steps with your pediatrician. Recommended care includes:

Monitor for Signs of Infection

Look for fever, pain, irritability, colored drainage, or foul smell from the ear as possible signs of infection while the eardrum heals.

Keep Ears Dry

While the tube hole is closing up, try to keep water out of the ears during bathing. Use ear plugs when swimming.

Follow Up Appointment

Schedule a visit for your doctor to inspect the ear and ensure proper healing after several weeks.

Watch for Persistent Fluid Buildup

Contact your pediatrician if you suspect lingering infection or fluid behind the eardrum after tube extrusion.

Avoid Smoke or Allergens

Prevent recurrence by limiting secondhand smoke and allergen exposure during the healing process.

Follow Ear Check Recommendations

Stick to your childs schedule for periodic ear evaluations to ensure no recurring problems.

While tubes falling out is part of the natural process, taking steps to facilitate healing prevents complications like chronic infections down the road.

When To Call the Doctor

In most cases, ear tubes coming out occurs uneventfully as a routine part of the process. However, call your doctor if your child experiences:

• Severe ear pain
• Bleeding from the ear
• Pus or foul-smelling drainage
• Fever over 102F
• Hearing loss or noises in the ear
• Dizziness, balance issues, or nausea
• Swelling around the ear

These could signal complications like an infection, residual hole, or injury to the eardrum after tube extrusion.

Reasons for an Urgent Ear Exam

Besides the above symptoms, urgent evaluation is recommended if:

• A tube has been out over 2 weeks but no improvement in hearing
• You suspect the tube has fallen into the middle ear space
• Your child has persistent earaches and infections despite tube placement
• A new recurrent ear effusion is suspected

Catching any lingering problems early prevents long-term ear and hearing damage.

Ear Tube Removal Appointment

If a tube fails to come out after a prolonged period, your doctor may recommend scheduling in-office surgical removal such as:

• After being in 2 years in children
• After being in 1 year in adults
• If a clogged tube causes recurring infection

Leaving a non-extruded tube in place long term risks permanent eardrum perforation or cholesteatoma growth.

Long-Term Ear Health After Tubes

While ear tubes successfully treat most childrens persistent ear problems, good long-term ear care is still important after the tubes come out. Recommendations include:

Follow Up With Hearing Tests

Routine hearing evaluations make sure any temporary hearing loss from chronic infection has resolved.

Monitor for Recurring Infections

Approximately 20% of children have repeat infections after tubes extrude, requiring re-evaluation.

Limit Secondhand Smoke Exposure

Ongoing smoke exposure raises the likelihood of recurrent effusions and ear infections.

Treat Allergies or Environmental Triggers

Controlling exposures to dust, irritants, or allergens that contribute to ear problems.

Consider Ear Plugs for Bathing

For younger children prone to infections, ear plugs for bathing may prevent recurrence by keeping water out of the ears.

Staying vigilant about follow-up care ensures your childs ear health remains optimized over the long term after tubes have served their purpose.

Key Takeaways

• Ear tubes commonly fall out on their own within 6-18 months as the eardrum heals.
• Mild drainage or spotting of blood is normal when a tube extrudes.
• The small hole left behind typically closes within 1-2 months.
• Severe pain, bleeding, or fever warrant urgent medical evaluation.
• Follow your childs ear check schedule to ensure no recurring problems.

Knowing what to expect when ear tubes fall out helps ensure this common occurrence passes smoothly and allows your childs ears to keep improving on their normal healing path.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.