Are ear tubes right for my child?

If you have any children under the age of six, chances are, you have already suffered through the agony of a middle ear infection with at least one of them. Statistics show that middle ear infections are the second most common childhood infection, and that two out of every three children will have at least one infection before the age of six. Middle ear infections can be viral or bacterial in nature. Bacterial ear infections can be treated with antibiotics, but for viral ear infections, the only real options are to treat the pain symptoms and to wait for the infection to clear up on its own, which can take anywhere from four to nine days (sometimes longer for very young children).

But what if your child has recurrent ear infections, or is having a problem with fluid behind the eardrum that persists for weeks or more? (It is common for there to be some fluid in the ear for two to three weeks after an ear infection, but longer than that would be cause to speak with your child’s doctor.) Antibiotics can be prescribed, but may not always be the best solution, especially given recent concerns about the over-prescription of antibiotics for ear infections in children. Another option is to have ear tubes inserted in your child’s ears, but it is important for parents to make sure that they understand the procedure, what results the procedure can and can’t produce, and what the risks may be before proceeding.

With over a half a million children having ear tubes inserted each year, it is one of the most common childhood surgeries of those requiring anesthesia. There are a number of benefits to this simple surgical procedure, including a reduced risk of future ear infections, improved balance and speech, better night-time sleep, and even, possibly, an improvement in behavioral problems being exhibited by your child. The procedure itself is short (thirty minutes or less, generally); children often experience immediate improved hearing from the fluid having been drained, and the recovery period is short as well (usually two to three days).

But even given the simplicity of the procedure and the possible benefits, some parents are still hesitant about undertaking it. It is, after all, surgery under general anesthesia, never something to enter into lightly. Furthermore, while tubes can provide some real relief for many children suffering from chronic ear infections or fluid in the ear, sometimes the surgery is recommended unnecessarily for children in cases where the problem could resolve itself or easily be treated with antibiotics. One study estimates that as many as twenty-five percent of ear tube surgeries were not necessary for the children receiving them, and put the number at thirty-three percent for children who would be considered only borderline in need of receiving them.

Any time parents are making the decision to embark upon a course of medical treatment for their children, a thorough understanding of the risks involved is extremely important, and the insertion of ear tubes does carry with it some risks, such as complications from anesthesia, perforation of or scarring in the eardrums, and chronic drainage from the ear. In addition, occasionally, if a first set of tubes does not solve the problem or one or both of the tubes falls out prematurely, repeat surgeries may be required. It should be noted that possible scarring of the eardrum does not always result in a loss of hearing, although that is one of the rare possible risks to consider; in addition, perforated eardrums may require later surgeries to repair them.

If your pediatrician or ENT (Ear, Nose, and Throat specialist) has recommended tubes for your child, you may wish to familiarize yourself with a recent study done by physician and researcher Jack L. Paradise His research focused primarily on ear tubes inserted in cases where a child had persistent middle-ear fluid, not cases where a child had repeated, painful ear infections. His findings were such that they brought about a change in the guidelines for recommendations of ear tube surgeries for children with persistent fluid in the ear, encouraging doctors to take a "Watch and Wait" approach combined with frequent hearing assessments to see if, over time, the problems resolve themselves on their own (the study showed that in a significant number of cases, they did.) However, the study did note that in cases where the child has a tested hearing loss of forty decibels or higher, or already has a documented language delay, tubes are, still, in fact, the recommended course of treatment.

In the end, it is up to the parents to make sure that they understand their pediatrician’s or ENT’s rationale for recommending the surgery; to verify, even with a second opinion if necessary, that their child is truly in need of the surgery (again, for recurrent, painful ear infections, or cases where there is already documented hearing loss or speech delays); and to understand the possible risks associated with the surgery before making the decision to proceed. Only then, will they be equipped to answer the question for themselves, "Are ear tubes right for my child?"