Ear Infections and Ear Tubes:
Pros and Cons of Surgical Treatment
What are ear tubes?
- When a child has multiple ear infections, small plastic tubes (also known as pressure equalization tubes) are sometimes placed in the ear drums to allow fluid to drain out of the ears properly and to allow pressure to equalize (i.e. allowing air to reenter the middle ear space)
- These tubes are considered temporary
- They will usually fall out on their own in 6 to 18 months
What happens in the surgery?
- The child is put under general anesthesia
- An ear, nose, throat specialist (i.e. ENT) makes a small cut in the eardrum and drains out any excess fluid
- The small plastic tube is fitted inside of the small cut
Why are they needed?
- The eardrum normally has an air space behind it and it vibrates in order to produce sounds
- If there is fluid behind the eardrum, the eardrum cannot vibrate properly and the sounds become muffled
- Ear tubes allow the fluid to drain out and for air to come back inside
What are the benefits/pros?
- Reduces (but does not eliminate) the risk of recurring ear infection
- If hearing was affected by chronic fluid in the ear, it can return hearing to normal
- Removing ear fluid can restore normal speech development
- Improving balance (since the inner ear is responsible for balance, chronic fluid or infections can affect that)
- Preventing fluid from becoming thick and causing more permanent damage in the middle or inner ear
What are the risks/cons?
- After tubes are placed some children still will have ear infections
- Tubes sometime fall out too quickly and may have to be replaced
- Tubes rarely can fall backward into the middle ear space and need to be surgically removed
- Tubes staying in too long (especially 3yr or more) – these may need to be removed by your ENT
- Tubes sometimes form scars on the eardrums or form a persistent hole – it is possible that these changes could result in a small hearing loss
- Rarely children may have complications from anesthesia
When can I expect that my doctor will recommend an ear tube surgery?
- If fluid has been present for more than 3 months straight
- Both ears have persistent fluid
- When the presence of fluid has caused a hearing loss and/or speech delay
- When there are 3 or more ear infections in a 6 month period or 5 ear infections in a 12 month period
- Ear infections that do not clear with trials of many different antibiotics
- When children have complications of severe ear infections – like facial nerve palsies or mastoiditis
Is there anything I can do to lower the risk of my child getting fluid in the middle ear in the first place so that they will not require ear tubes?
- Never have children lying flat while drinking their bottles as this may lead to milk backing up into the middle ear space
- Do not smoke around children
- Control any allergies that exist as these may lead to more ear infections
- Watch for persistent snoring. This may be a sign of large adenoids which may lead to chronic congestion and ear infections