My daughter has tubes in right now, and from what her ENT has told me, if they don't fall out on their own, there is a risk of infection, which could severely damage the eardrum. Also, even if there is no infection, she would have to always wear earplugs when bathing or swimming and always cover her ears when it's cold and windy (that hurts when you have tubes in). If she did get bath water, or water from a lake or swimming pool in her ear, it would cause an ear infection. That's not something I'd want to deal with forever! I think the surgery is absolutely necessary, considering the risks and inconveniences if the tube was left in place.