John Carew, MD, is board-certified in otolaryngology and is an adjunct assistant professor at New York University Medical Center.
Fortunately, most kids only get a few ear infections (called otitis media), if any, per year. But if your child gets recurrent infections, your pediatrician may recommend inserting ear tubes. Here's what to know about how many infections warrant tubes, what your healthcare provider will take into consideration when suggesting them, and how to weigh the benefits and risks of this surgery.
Babies and children are at higher risk of getting ear infections than adults because:
Having respiratory allergies and a family history of ear infections increases the risk.
Ear tube placement surgery is the most common elective surgery in children in the United States. Ear tubes are tiny cylinders placed through the eardrum (tympanic membrane) to allow air into the middle ear. They are called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. The tubes can be made of plastic, metal, or Teflon, and may have a coating intended to reduce possible infection.
There are no cut-and-dry rules for when tube placement surgery is indicated. Many experts consider tubes for a child who has had three ear infections in six months or four ear infections in 12 months. Others decide to place tubes when infections are frequent and close together, particularly painful ear infections, or when an ear infection does not clear after a period of time with appropriate antibiotics.
Tubes are also recommended when a child has fluid in their ears (otitis with effusion) for more than three months and/or temporary hearing loss.
By far the most important benefit of ear tubes is that they improve the quality of life for many children, especially in cases where hearing is affected. Hearing problems can have a negative effect on learning and behavior.
Ear tube surgery usually lasts half an hour or less. Your child will be sedated and should not have much, if any, pain. Complications may occur with any surgical procedure. Possible complications of ear tube surgery include:
Although some children have complications after getting ear tubes, they are rarely serious. Numerous studies have shown improved quality of life outcomes for children after getting tubes.
If you can reduce the number of ear infections for your child, you may lower the chances that she will need ear tubes. Certainly, this is not always possible, and even the most attentive and caring parents frequently have children who end up needing ear tubes. Some measures that may possibly make a difference include:
If you think your child has had too many ear infections, ask your pediatrician for a referral to a pediatric ENT specialist to discuss if ear tubes would be appropriate. A pediatric ENT doctor can also provide a second opinion if you think your pediatrician is recommending tubes unnecessarily.
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