Tubes for ear Infections

It used to be the norm for toddlers to get tubes in their ears when they suffered frequent ear infections. Tubes, also called tympanostomy tubes, allow fluid that had built up behind the eardrum to drain, relieving pain and allowing a child to hear better. However, research has found that tubes may not be needed as often as previously thought. Not only that, but the overuse of tubes could do more harm than good.

Ear infections are often treated with antibiotics, though even that isn’t always necessary. Sometimes numbing drops and an OTC pain reliever may be enough to manage discomfort until the infection clears up on its own. This should always be discussed with your doctor, who will know if antibiotics are truly needed or not.

For children with frequent ear infections, parents may feel frantic to resolve the problem so their little one feels better. Tubes seem like a simple solution. The surgery is done under general anesthesia and children can usually go home a few hours after the surgery. However, tubes are not without possible complications. Aside from the expense, ear tubes have the potential to cause scarring and may also leave the child with a perforated eardrum, which can cause hearing loss, speech delays, and other issues. Consider, too, that some children have tubes put in more than once.

In a study published in the New England Journal of Medicine, researchers found that in children with fluid behind their eardrums for at least three months who also had mild to moderate hearing loss, there was no difference in the development outcomes of children who received ear tubes and those who did not.

Other studies found that, on average, children who get tubes in their ears have greater damage and more hearing loss than children who do not. And children who experience developmental delays when very young tend to outgrow them and catch up developmentally, even without treatment with tubes.

Of course, the result of this research does not indicate that tubes should never be used. In fact, the American Academy of Pediatrics recommends that tubes may be indicated in children who have three episodes in six months or four episodes in a year.

For some children, it may be better to wait for your child to outgrow ear infections, which typically clear up by the time a child is 3 or 4 years old. Some doctors recommend watching the child and rechecking every 3-6 months to see if the problem gets worse before jumping into surgical treatment. In most cases, the problem will go away on its own if the child is otherwise healthy. In other cases, such as in children with Down Syndrome or a cleft palate, tubes may be needed sooner.

In any case, instead of insisting on tubes that may not really be needed, discuss your options with your doctor and an ear, nose, and throat specialist to decide if surgery is really the best option for your child.

Sources:

• Pediatrics
• The Diagnosis and Management of Acute Otitis Media.
  ENT Today
• Pediatric Ear Infections: Watchful Waiting May be the Best Strategy.
  HealthyChildren.org
• Middle Ear Infections.
  Mayo Clinic
• Ear Tubes.
  Pediatrics
• Otitis media in Early Childhood in Relation to Children’s School-Age language and Academic Skills.
  The New York Times
• Are Ear Tubes in Your Child’s Future?
  The New York Times
• Ear Infection? Think Twice Before Inserting a Tube.

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