Should my child get ear tubes?

An ear infection, also called otitis media, occurs when fluid builds up behind the eardrum, often causing pain, pressure, fever and temporary hearing loss. Recurrent ear infections are defined as 3 episodes in 6 months, or 4 episodes in a year. This condition is the primary reason for the placement of tympanostomy tubes, often called “ear tubes”, which help facilitate ventilation and drainage of fluid from the middle ear. 

Your child’s pediatrician or ear, nose, and throat (ENT) specialist may recommend ear tubes if your child has any of the following:

  • chronic ear infections with tearing or perforation of the ear drum
  • hearing loss due to a buildup of thick fluid behind the ear drum that persists longer than 3 months
  • blockage of the Eustachian tubes

It’s also common practice for your child to receive a hearing test when being assessed for ear tubes. Unless a hearing deficit is noted (which could impact speech development), even children with persistent fluid behind the middle ear may not need ear tubes. 

What happens when you get ear tubes?

For children who do require ear tubes, placement is an outpatient procedure that usually takes about 15 minutes. After anesthesia has been administered, the otolaryngologist makes a tiny hole in the eardrum, suctions out the fluid from the middle ear, and inserts the tube into the hole in the eardrum. “Short” or “long” tubes may be used. Your child will need to see the otolaryngologist or his pediatrician every 4–6 months while the tubes are in place. He will also need to have a hearing test after the procedure. 

Ear tubes usually fall out on their own after 6–12 months, although sometimes they do need to be surgically removed when they are no longer necessary (as the child grows, his ear canal is better able to drain naturally without intervention). In some cases, the procedure may need to be repeated, if the tubes fall out too soon, or are removed due to ear infection.

The effectiveness of ear tubes 

According to the AAP, since the risks and benefits are about equal, pediatricians must determine the appropriateness of the procedure for each individual, on a case-by-case basis in discussion with the child’s parents or caregivers. 

For children with a history of ear infections, potential benefits can include: 

  • decreased risk of ear infections
  • decreased risk of speech delay
  • improvements in hearing, speech, behavior, and sleep

Risks associated with ear tubes can include:

  • general risks associated with anesthesia and surgery
  • scarring of the tympanic membrane
  • chronic perforation of the membrane
  • hearing loss and/or speech problems
  • fluid leaking from the ear

Benefits and risks should be thoroughly discussed with your child’s health care provider. And remember, ear tubes don’t guarantee that your child will be free of ear infections but at the very least, they should occur less often.

Last updated September 19, 2020

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