Ear Tubes: Who Needs Them

The eardrum vibrates with sound because the space behind it is filled with air. If it's filled with fluid, the hearing is muffled. This happens with ear infections. Sometimes the infection clears with antibiotics, but the fluid remains. Usually the fluid clears over 2 to 4 months. If not, your healthcare provider may suggest ear tubes -- also called ventilation tubes.

The benefit of inserting small plastic tubes in the eardrums is that they allow the middle ear space to drain and dry out. This brings the hearing back to normal.

The risk of tubes is that sometimes they cause scarring of the eardrum or a small hole that doesn't heal. So it's worth asking, who really needs tubes? An expert panel of the American Academy of Pediatrics established the following guidelines. Your child needs tubes if:

  • First: Both ears are filled with fluid.
  • Second: The fluid has been present for over 4 months; and
  • Third: The fluid has caused a speech delay or a documented hearing loss of at least 20 decibels. Insist on a hearing evaluation before signing a consent for tubes.
  • Fourth: Severe ear infections are a separate reason for ear tubes. This includes 3 or more ear infections within a 6 month period or ear infections that are unresponsive to multiple antibiotics. These are appropriate indications for placing tubes. Unless these criteria are met, your child doesn't need tubes. Be cautious about surgery. A recent study showed that 50 percent of tube placements were unnecessary and inappropriate.
  • Finally: Most children just have temporary ear fluid and a mild hearing loss. During that time, when you want to talk with your child: move close to him, make eye contact, and speak a little louder than you usually do. Do this until the fluid resolves on its own. Time is on your side.

 

If your have other questions about ear tubes, consult your healthcare provider.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. FAAP

Last Review: 6/1/2008

Last Revised: 7/1/2005

Copyright 1994-2008 Barton Schmitt, M.D. Parent Advice Messages.

 

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