Care4Kids

Ear Tubes

Infection and inflammation of the middle ear, also known as otitis media, is one of the most common diseases in early childhood, particularly for children ages 6 months to 6 years. More than three out of four children have experienced at least one ear infection by the age of 3. Roughly one-third of them will suffer three or more infections. Otitis media occurs when the space behind the eardrum (the middle ear) is full of infected fluid.

Young children are more susceptible to otitis media because their eustachian tubes are shorter and nearly horizontal, making it easier for bacteria to reach the middle ear. Plus, their bodies’ defenses aren’t well developed at fighting off infection. Depending on your child’s age and the severity of the infection, an untreated ear infection could cause permanent damage to the ears, possible hearing loss and speech delays.

SYMPTOMS

Very young children can’t tell you where it hurts, so it is up to you to be alert to the following symptoms of ear infections:

Call your child’s doctor if any of the above symptoms exist. He can determine if treatment is necessary, only after looking into the ear at the eardrum.

RECURRENT EAR INFECTIONS

Several factors can predispose a child to recurrent ear infections. Children on bottles should not drink while lying flat or have a bottle in bed. The proper position to drink from a bottle is with the baby’s head elevated. Children older than 18 months should not drink from a bottle unless they have other developmental problems.

Second-hand cigarette smoke also predisposes children to more respiratory infections, including ear infections. Children in day-care settings usually have more respiratory and ear infections, as well.

Although ear tube surgery is very common, it isn’t usually the first course of treatment for recurrent ear infections. Antibiotics are the most effective primary treatment for bacterial ear infections.  If your child’s infections repeatedly fail to respond to antibiotics, or if they are chronic and recur frequently, ear tube surgery may be suggested to drain the fluid.

TREATMENT WITH SURGERY

The most common surgical procedure is called myringotomy, during which the surgeon creates a tiny hole in the eardrum. Pressure-equalizing tubes – or “PE tubes” – are placed in the tiny hole so air can enter the middle ear to allow ventilation, aid fluid drainage and restore normal hearing. Surgery is usually performed on an outpatient basis by a doctor who specializes in the treatment of problems related to the ear, nose and throat. Your child’s total time in the hospital is usually about two to three hours. Here’s what you can expect:

CARE OF THE EARS AFTER SURGERY

It is very important that no water enter the ear canal. If water passes through the tube and into the middle ear, it could cause an infection. Remember, it is still possible to get an ear infection with the tubes in place. Your son’s doctor may have you use earplugs when he is swimming or bathing. Moldable wax earplugs work well and can be found inexpensively at most drug stores.

WHAT HAPPENS WHEN THE TUBES FALL OUT

Ear tubes generally stay in the ear anywhere from six to 18 months. The tube is pushed out as the eardrum grows. When this happens, the tube is designed to fall outward, into the ear canal. Once this happens, your doctor may remove it in the office, if it hasn’t already fallen out of the ear on its own. You probably won’t notice when the tube falls out because it is so small. Once the tube falls out, the hole in the eardrum will close and your child’s own natural ear ventilation will prevent ear infections and the accumulation of fluid.

Tubes allow ventilation while your daughter’s ears mature. In an ideal situation, by the time the tubes fall out, her ears will have outgrown the problem. However, this isn’t always the case and about 25 percent of children who need ear tubes before the age of 2 will need tubes again.

WHERE TO GET MORE INFORMATION

To help determine whether your child is a candidate for PE tubes, talk to your pediatrician or an ear, nose and throat specialist.


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