June 27, 2017

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Does My Child Need Tubes in Her Ears?

Recurrent ear infections can take a toll on the entire family.  You might think your child has an ear infection so you go to the doctor, the doctor confirms that there is an infection, the medicine runs its course and yet soon it seems you are back for the same reason.  What can you do? The solution just may be putting tubes in the ears.

How many ear infections are too many?

The most common reasons to put tubes into a child’s ears is because of recurrent ear infections and to improve hearing for children with chronic fluid; especially in instances where they have speech delay.  I usually talk to parents about considering tubes if there have been three or more infections in the past six months, four or more infections in the past year, or fluid present for three months or longer without going away. Our goal is to improve hearing and reduce the rate of infections while enhancing the quality of your child’s life so that they aren’t having so much pain and so many sleepless nights.

Will tubes prevent future infections?

Once the tubes are inserted into your child’s ear, the chances for getting recurring ear infections is reduced significantly.Now and then I have a patient that will have an episode, but it isn’t as common.  When the tubes are inserted into the ear, they allow excess fluid in the ear to drain out of the hole in the tube; without a tube present, this fluid would build causing pressure and pain.  Also, when tubes are present, if your child does get an ear infection we can treat the infection with drops instead of oral antibiotics and they won’t have any side effects to deal with such as diarrhea or rash.

Is it a dangerous procedure?

Putting tubes into the ears is not considered to be a high risk procedure.  In fact, when we put them into the ears of adults we do the procedure in the office.  In children, it can be more difficult to get them to sit still and so that is why we take them to the operating room where we can give them an inhaled anesthesia through a gas mask, which is usually pretty well tolerated by most kids.  About an hour or so after the procedure kids are back to their normal activities.

Following the procedure I tell parents to watch for fluids draining from the ear and occasionally there can be a fever for a day or two and if they have any concerns that we should follow up with them to make sure all is ok.

Can the tubes fall out?

Tubes will generally fall out by themselves within a year of the surgery and the ear drum heals all on its own.  We used to tell our patients that if they had tubes in that they should be concerned with keeping their ears dry and to use ear plugs when taking a shower, bath or going swimming.  The current research shows that you really only need to be concerned when you are going 3 or 4 feet under water.  So if you just stick to surface swimming along with normal bathing routines your child’s tubes will be fine.  Occasionally the tubes fall out too fast and need to be reinserted and sometimes they don’t fall out at all.  If it has been three years or longer and the tubes still haven’t fallen out, I recommend having them removed.

What about scarring?

Jonathan Mellema, M.D., Otolaryngology (ENT), ACMC-Willmar, Litchfield, Marshall

Tubes and infections can leave behind some scarring, but usually it’s not enough to cause any hearing loss because it takes a lot of scarring to cause damage to the ear drum.

Putting tubes into your child’s ears is a pretty low-risk procedure and it’s a pretty high reward as far as improved quality of life.  Most kids will grow out of getting recurrent infections whether you put tubes in or not; but if you are making several trips to the doctor’s office and your child is taking more than their fair share of antibiotics then tubes just might be the safest option.

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