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Ear Tubes for Chronic Ear Infections

Each year, more than half a million ear tube surgeries are performed on children, making it the most common childhood surgery performed with anesthesia. Children who receive these surgeries are typically between the ages of 1–3. What are ear tubes and how might it help your child? Boys Town Ear, Nose and Throat​ is here to answer your questions.

When is it time to get ear tubes?​

Many children experience ear infections (also known as Otitis Media), especially between the ages of 6 months and 2 years and the problem can be common until the age of 8.

  • Painful ear infections can develop when fluid is trapped in the middle ear and is especially common during the cold and flu seasons.
  • While most children will have at least one ear infection, over one-fourth of these children will have repeated infections.
  • Inserting ear tubes by an otolaryngologist (ear, nose and throat specialist) may be considered with recurrent ear infections that may cause your child to be sick frequently, not sleeping well, behavior or speech problems and possible hearing loss.

What are ear tubes and how are they placed?

Ear tubes are small cylinders with a tiny hole through the center that are placed through the ear drum (tympanic membrane) to allow fluid to drain and relieve pressure.

  • The (Eustachian) tube, it may also be called, Tympanostomy, Myringotomy, Ventilation, or PE (pressure equalization), creates and allows an equalization of air pressure between the outer ear and the middle ear by replacing air that has leaked out into the surrounding tissue.
  • There are two types of ear tubes:
    • 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 stay in place for a longer period of time and may fall out on their own but removal by an otolaryngologist may be necessary.
  • ​​The procedure lasts about 10 minutes and requires a short general anesthetic. During surgery, a tiny hole is placed in the ear drum where the ear tube is placed allowing the removal of fluid from the middle ear.

How will ear tubes help my child?

Ear tubes can help decrease hearing loss and return your child’s hearing to normal as well as reduce chronic ear infections and improve speech delays and articulation. Ear tubes do not eliminate colds or nasal drainage and may not completely remedy all ear infections and illnesses but your child is likely to benefit from quality-of-life health improvements. If your child is having recurrent ear infections, talk to your child’s doctor or contact an ear, nose and throat specialist.

 
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    Ear Tubes

    Jane M. Emanuel, M.D.

    Otolaryngologist

    Boys Town Ear, Nose & Throat Institute

    Ear tubes have a couple of different names. One of the formal names is pressure equalizing tubes or ventilation tubes. Basically, that's what they are. They are little tiny plastic tubes, put in the eardrum to equalize the pressure and let air in behind the eardrum. So, that the fluid or recurrent infection troubles you're having are less likely to happen.

    When is placing tubes necessary?

    There are some certain guidelines that we look at but a lot of times it's a combination of a number of factors. The major reason we'll put ear tubes in is consistent fluid behind the eardrum, which is usually after an ear infection in kids. It's usually after the fluid has been there a period of months, often times, a period of three months if they're not having any other complicated things.

    It's usually not just simply fluid. There's usually some combination of repeated infections during that time frame. We also look at how much this is impacting the hearing, if the child already has speech delay or some other issues, that may change the time frame.

    How can placing ear tubes help a child?

    If you have a fluid behind your eardrums, you'll have a mild hearing loss. It's about a 25 decibel hearing loss. You can still hear, and parents will come in and say, I know they can hear because they will respond, but it still does give you a hearing loss.

    Once you put the tube in, you let air in, fluid goes away and everything goes back to normal. Then you also have better plumbing so you're less likely to get acute ear infections as well.  

    Some kids with ear fluid it really affects their balance, other kids it does not, but it certainly could make a difference.

    It certainly makes a difference in speech development especially in that one-year old, two-year old. If they're walking around with a hearing loss for a month they aren't going to develop speech as well, so there's certainly a benefit from that. We use tubes aggressively in our kids who have speech delay.

    How are tubes placed?

    Putting tubes in is going to require a general anesthetic, a short out-patient anesthetic. They are asleep for about five or eight minutes with that.

    When we're doing that we look through the microscope, look at the eardrum, and make a tiny, little millimeter cut in the eardrum. We suction our fluid from behind the eardrum and then we slip the ventilation tube in that opening.

    Basically, the tube is to keep the hole open. If we just made the cut and sucked out the fluid, that little cut will heal within a few days. The tube keeps the hole open so it keeps air going back and forth and makes the plumbing of the ear better and they have less troubles.

    It's very routine for us. It's never routine for you when it's your child having the procedure but it's something we do multiple times per week. You come in and go home in a period of a couple of hours and generally, back to daycare, back to normal activities tomorrow.

    How long do the tubes stay in?

    Tubes do require a little bit of after care. We usually see kids back a couple of weeks afterwards and make sure everything looks good. Then we do want to check the tubes every six months either with an ENT or your primary care physician to make sure they come out as well.

    Tubes grow their way out. It's not like they all of a sudden pop out. If you see one fall out of your child's ear, it's actually been in their ear canal for awhile.

    They stay in, varying by the type of tube we put in, usually about a year. A year is average, some will come out six or eight months, once in awhile one will plug up, some stay longer.

    A few of them don't come out which is why we check kids very six months. If they don't come out in the two or three-year time frame from when we put them in, we are going to start talking about a small surgery to take them out as well.

Ear, Nose and Throat;Surgery and Hospital Care

 

 

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