After repeated ear infections, when is the right time for ear tubes? Pediatric ear, nose and throat specialist Dr. Gillian Diercks walks us through what to consider.
Ear infections are incredibly common among children, and while they often resolve on their own or with the help of antibiotics, sometimes they just keep coming back.
Children with repeated ear infections, or persistent fluid in their ears after an infection clears up, can be at risk for significant antibiotic exposure, hearing loss and/or speech delays. In these instances, doctors typically recommend ear tubes.
What are ear tubes?
Ear tubes are tiny plastic or metal cylinders that are surgically inserted into the eardrum. They help to prevent the development of negative pressure and fluid build-up by allowing air to flow into the middle ear.
They are recommended for those who have repeated ear infections that don’t seem to get better — or when persistent fluid is present in the middle ear.
“Most patients undergoing tube placement are under the age of three, because this age group is more likely to experience difficulties due to the immaturity of their ears,” said Gillian R. Diercks, MD, pediatric ear, nose and throat specialist at Massachusetts Eye and Ear.
“It’s the most common outpatient pediatric surgery in the United States,” Dr. Diercks continued. “In fact, more than half a million ear tube surgeries are performed on children each year.”
When to see a specialist
Because repeat ear infections can have a damaging impact, it is important see an ear, nose and throat specialist at the right time. The main factors that should influence this decision are:
- Number of ear infections in the past year
- Antibiotic usage (especially if your child has an allergy to medication)
- Speech delays
- Hearing loss concerns
“Pediatricians will likely refer children who’ve had more than three ear infections in six months or four ear infections in the last year to a specialist, especially if there’s concern about overuse of antibiotics, a speech delay present or persistent middle ear fluid after infections have cleared,” said Dr. Diercks.
Preparing for your appointment
Once your child is scheduled to see a specialist, prepare for the appointment by gathering information on the number of ear infections your child has experienced over the last year and the results of any past hearing tests.
It is also recommended to prepare your own questions to help you better understand what your child is going through. Consider questions about expected short- and long-term outcomes, associated risks and alternative treatments to cover your bases.
At the appointment, a comprehensive physical exam and hearing test will be performed. Patients who are not yet candidates for surgery are recommended to continue using antibiotics and seeing their doctor regularly.
“Not all patients with recurrent ear infections will be candidates for ear tubes,” said Dr. Diercks. “Either way, we will council you and your family through our recommended options, and continue to do the necessary follow-ups to monitor your child’s health.”
What happens in surgery?
During surgery, known as a myringotomy, doctors make a small incision in the child’s ear drum and place the ear tube there to keep the incision open for ventilation.
It’s an outpatient procedure that only lasts about 15 minutes, and children are able to go home the same day.
Most children require general anesthesia, so your child may experience mild grogginess or nausea afterward.
“Ear tube procedures are extremely common and safe,” said Dr. Diercks. “Most children do not have any trouble or discomfort following surgery, and are back to their usual routine the next day. Families usually see improvements in hearing right away, while speech and language delays may take a bit longer to improve.”
Ear tubes can last anywhere between six months to two years. Follow ups will occur with hearing tests starting about four weeks after surgery, then every six months until the ear tubes fall out on their own.
“Any surgery is a scary thought. Knowing what to expect and what questions to ask can help ease your mind as a parent,” said Dr. Diercks. “The best thing you can do for your child is to prepare and to know when to seek a professional opinion.”
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