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When Should Your Pediatrician Send Your Child to an ENT?

It used to be common practice that if a child suffered from an ear infection, antibiotics were given to clear it up. But the American Academy of Pediatrics (AAP) recently changed its position on the treatment of acute otitis media (the medical term for an infection of the middle ear) and now recommends less medical intervention and a “wait and see” approach for certain children with less severe symptoms.

Otitis media occurs when the narrow passage connecting the middle ear to the throat swells, and fluid and pressure build behind the eardrum. Although it can be painful, studies show that about 80 percent of ear infections clear up on their own within a week, with 60 percent of kids feeling better in just one day.

When to see an ENT

Whether your child fights off an ear infection with or without antibiotics, remember the fluid left in the middle ear (doctors call it “effusion”) can linger for weeks. It usually clears up entirely within a couple of months, but if your child keeps getting ear infections, or if the fluid doesn’t disappear, a trip to the ear, nose, and throat specialist (ENT) is in order. AAP recommends that children with recurrent ear infections be evaluated by an ENT. Recurrent otitis media is defined as more than three episodes in six months or four episodes in one year (with one episode in the preceding six months). You’ll want to see a specialist sooner if your child is also dealing with language delays, learning problems, or a significant hearing loss in addition to the ear infections.

After your consultation, the ENT may decide a myringotomy (an operation to remove the fluid) and a tympanostomy tube insertion is the best course of action. During the procedure, a small incision is made in the eardrum to drain the fluid and then a small tube is left in place to prevent the hole from closing. Don’t worry: the surgery typically takes about 15 minutes under a light, general anesthesia. The tubes usually fall out by themselves in 6-12 months, and if not they can be easily removed by the ENT.


  • American Academy of Pediatrics: PEDIATRICS Vol
  • 131 No
  • 3 March 1, 2013 pp
  • e964 -e999  (doi: 10.1542/peds.2012-3488)
    University of Iowa Children’s Hospital
  • Ear Infections in Children
    Mayo Clinic
  • Treatment and Drugs.

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