Ear tube Granulomas and Granulation Tissue

Ear Drainage is a common occurrence in children who have ear tubes. The drainage is usually from one of two sources:

Middle Ear Infection: Even though ear tubes should prevent middle ear infections, they still can occur. Often they occur because water gets into the ear. Over 33% of these infections are caused by a bacteria called "pseudomonas". Oral antibiotics in children are not effective. These infections should be treated by ear drops.
Ear Tube Granulomas: The eardrum extrudes the ear tube by a slow process and sometimes during this process an ear tube granuloma (or granulation tissue) forms which causes bleeding and drainage.

		Normally the ear tube sits in the eardrum, held in place with an inner and outer phalange.
			The inner layer of the eardrum heals behind the ear tube and begins to push it out. This causes the tube to plug while it is still in the eardrum.
		In cases of "granuloma" formation the inner layer of the eardrum will sometimes grow out through the tube's lumen and a mass of blood vessel forms over the tube. This mass of blood vessels forms a ball which can fill the ear canal. It often bleeds and drains pus.
		In other cases of "granuloma" or granulation tissue formation, the granuloma may form next to the ear tube.

Treatment: Treatment consists of steroid containing antibiotic ear drops and removal of the granuloma. Using ear drops alone will often melt the granuloma away over two to three weeks. However, the most effective way to resolve the infection is to remove the granuloma. Because there are no nerve endings in the granuloma it can almost always be removed in the office. It is only attached to the tube by a thin stock and often it can be removed by applying a small amount of suction. Bleeding is brisk but will stop after a cotton ball is placed in the ear canal.