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Ear Tubes
By Kevin Stuckey, M.Ed., CCC-SLP
Painful ear infections are a common occurrence in children under the age of five, but can also be present in teens and adults. Most ear infections resolve on their own (viral) or an otolaryngologist (ENT - ear, nose, and throat specialist) can effectively treat the infection with antibiotics (bacterial). Sometimes ear infections and/or fluid in the middle ear may become a chronic problem leading to other issues, such as hearing loss, poor school performance, or behavior and speech problems. In these cases, the ENT may consider insertion of an ear tube. Each year, ENTs perform more than half a million ear tube surgeries on children, making it the most common childhood surgery performed with anesthesia. The average age for ear tube insertion is one to three years old.
What Are Ear Tubes?
Ear tubes are tiny cylinders placed through the eardrum to allow air into the middle ear as well as allow any trapped fluid to drain out. There are two basic types: short-term and long-term. Short- term tubes are smaller and typically stay in place for six to twelve months before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist may be necessary.
Who Needs Ear Tubes and Why?
Doctors suggest ear tubes for children who experience repeat ear infections or has had fluid behind the eardrum in both ears for more than 3 months causing significant hearing loss in both ears. The placement of ear tubes can help with ear infections because they:
  • Allow air to enter the middle ear.
  • Allow fluid to flow out of the middle ear through the tube into the ear canal.
  • Clear the fluid from the middle ear and restore hearing.
  • Prevent future buildup of fluid in the middle ear while they are in place.
  • Decrease the feeling of pressure in the ears, which reduces pain.
How Are Ear Tubes Inserted in the Ear?
An ENT places the ear tubes through a small surgical opening made in the eardrum during an outpatient surgery procedure. The procedure typically lasts less than 15 minutes. After the ear tubes are in place, the ENT may prescribe eardrops to administer in the following days. Children usually recover quickly and have little pain or other symptoms after surgery. Children can usually go home within 1 to 2 hours after the surgery. Your child will probably be able to return to school or child care the next day.
Inserting ear tubes may:
  • Reduce the risk of future ear infection.
  • Restore hearing loss caused by middle ear fluid.
  • Improve speech problems and balance problems.
  • Improve behavior and sleep problems caused by chronic ear infections.
  • Help children do their best in school.
What Happens After Surgery?
Follow-up visits to the doctor are very important after having ear tubes inserted. The doctor checks to see whether the tubes are working and whether the child’s hearing is improving. Surgery will immediately resolve hearing loss caused by the presence of middle ear fluid. Children with speech, language, learning, or balance problems may take several weeks or months to fully improve. Also, ask your doctor if your child needs to take extra care to keep water from getting in the ears.
After the tubes are out, watch your child for signs of ear infection or fluid behind the eardrum. Consult an otolaryngologist (ENT - ear, nose, and throat specialist) if your child experiences:
  • Repeated or severe ear infections not resolved with antibiotics
  • Hearing loss due to fluid in the middle ear
  • Barotrauma (injury to the eardrum as a result of changes in barometric pressure)
  • Anatomic abnormalities inhibiting drainage of the middle ear.
Resources
“Ear Tubes”, American Academy of Otolaryngology-Head and Neck Surgery, Retrieved 4-20-17 http://www.entnet.org/content/ear-tubes
“Tubes for Ear Infections”, WebMD, Retrieved 4-20-17 http://www.webmd.com/cold-and-flu/ear-infection/tubes-for-ear-infections
 
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