Is it Time for Ear Tubes?
Which is the better choice? Recurrent ear infections or ear tube surgery?
Your baby is fussy and seems to be in pain. It looks like they have an ear infection. Another one. Chronic ear infections can be a problem for many small children, but how do you know when it’s time for them to get ear tubes?
What causes ear infections?
The middle ear is an air-filled cavity separated from the outer ear canal by the paper-thin eardrum. The Eustachian tube is the passageway that connects the middle ear to the back of the nose. This passageway allows air pressure to equalize and prevent fluid from accumulating in the middle ear space. If the Eustachian tube is not working well, middle ear problems, including recurrent ear infections, can develop.
In children, the Eustachian tube is often dysfunctional due to its small size and swelling from respiratory infections. Without ventilation, a vacuum draws fluid into the middle ear space, creating a risk of infection or persistent fluid. Signs of ear infections can include ear pain, trouble hearing, fever, and ear drainage.
While middle ear infections cause pain and irritability, another concern is the impact they have on hearing. The fluid prevents the eardrum from moving appropriately, so sound does not get conducted to the inner ear. If a child has recurring ear infections, the constant blocking of sound can impact their speech development.
How are ear infections treated?
The best way to try and keep children from getting ear infections in the first place is to keep them away from sick children or other aggravating factors, like secondhand smoke. Yet despite the best hygiene efforts, many children will still suffer from ear infections. Additionally, if a child’s parents were prone to ear infections when they were young, their child has an increased chance of getting ear infections, too.
The standard treatment for ear infections is a course of oral antibiotics. However, if ear infections recur frequently, or if fluid persists in the middle ear, the doctor may suggest your child get ear tubes.
Ear tubes are soft, tiny cylinders placed through the eardrum that allow air into the middle ear. Short-term tubes are smaller and typically stay in place for six months to a year before falling out on their own. Long-term tubes are larger and secured in place for a longer period of time.
Ear tubes are a good solution for children with recurrent ear infections or persistent middle ear fluid that creates hearing loss. Tubes ventilate the middle ear space, bypassing the dysfunctional Eustachian tube.
Ear tubes benefit patients in several ways. First, they very often decrease or eliminate ear infections. If an infection does occur when tubes are in place, the infection can be treated with medicated ear drops, avoiding the need to use oral antibiotics. Restoring normal hearing by removing fluid from the middle ear space is another benefit of ear tube placement.
Ear tube surgery is very safe, with about 700,000 cases performed each year. The procedure takes about 10-15 minutes, with the child briefly asleep under light anesthesia.
Dr. Tebbit is an otolaryngologist who specializes in comprehensive adult and pediatric ENT care. He practices in CEENTA’s Belmont office. CEENTA doctors have been involved with ear tube surgery since the very beginning, as ear tubes were actually invented by CEENTA’s own Beverly Armstrong, MD, in 1952.