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By Dr. Steven Gold, Charlotte Eye Ear Nose & Throat Associates, P.A.
Many parents have this question on their minds when their child is prescribed a third, fourth, or fifth antibiotic for an ear infection. They know that “tubes” are often recommended for children with recurrent ear infections, but aren’t sure when this is a good idea or how this decision is made.
Dr. Steven Gold from Charlotte Eye Ear Nose & Throat Associates says “Many parents are surprised to learn that in most cases, the most important factor is not so much the number of ear infections, but what is happening in the ears in between the infections.” During an ear infection, there is usually fluid which develops in the middle ear space behind the eardrum. When the infection is treated, the fluid usually gets absorbed and disappears. However, in many cases, the fluid stays in the middle ear space even after the infection clears up. This is uninfected fluid and usually causes no obvious symptoms; children with this fluid don’t have the fever or pain they often get with full-fledged infections. However, this fluid can cause hearing loss (this is temporary and the hearing returns to normal when the fluid is gone), and the fluid is a nice soup in which new bacteria like to grow, so infections tend to recur frequently in children with chronic fluid in the middle ears. Since the fluid often causes no symptoms, parents may not know it is there unless a physician examines the child and sees it.
A simple rule of thumb is that if a child has fluid in the middle ears for more than 3 months, it is time to consider insertion of ventilation tubes. Of course every child is different and in some cases this surgery is recommended after a shorter or longer time period. These tubes allow any middle ear fluid to drain or evaporate, and eliminate the hearing loss and the increased chance of infection caused by the fluid. The surgery to insert the tubes is minimally invasive with an extremely low incidence of complications, but it does require a brief (perhaps 10 minute) anesthesia, so the decision to proceed is not made lightly.
If you believe your child may be a candidate for this procedure, talk with your child’s pediatrician or make an appointment with an otolaryngologist at Charlotte Eye Ear Nose & Throat Associates to get the answers you need to help you decide if “tubes” are right for your child.