The tubes fall out of the tympanic membrane into the ear canal on their own. There are several styles of tubes, and each falls out at different times. Some are designed to stay in for years. They are best removed after three years if they do not come out on their own. They cannot be dislodged by normal child's play.
Many children swim with tubes without infection.
The eardrum is closed if a hole or perforation is left in it if the drum fails to heal. Sometime perforation may act as a tube and allows extra drainage and ventilation for children who have not outgrown ear infections. Sometimes improvement of the ear ventilation is not enough to stop pus or fluid from forming behind the eardrum. Pus will drain out of the ear rather than build up behind the eardrum if the tube is open. Another factor of hearing loss is glue ear.