By Dr. Ellen M. Friedman, Pediatric Otolaryngologist at Texas Children’s Hospital
Battling frequent ear infections in infants is a common obstacle for new parents. If repeated courses of medications have not worked, there is a simple operation that is highly effective.
Getting ear tubes is a relatively small surgical intervention that can help children battle chronic ear infections, persistent fluid in their ears and help them with their hearing. Children of different ages need tubes for different reasons, but the vast majority of children who undergo this surgery are between 6 and 12 months of age.
The otolaryngologists at Texas Children’s Hospital perform 3,000 to 4,000 of these surgeries every year, indicating it’s a common surgery needed by a high percentage of the pediatric population. There are a wide variety of reasons that children have ear tubes inserted. The child’s language development, speech development, and different elements of their intellectual development will impact how we decide who will benefit from the tube surgery. The basic national guidelines for tube placement include: more than six infections in one year; greater than 30 conductive hearing loss in either ear; a speech, language or learning delay; or other special circumstances. Some of these special circumstances include having Down Syndrome, a cleft palate, or another underlying medical condition that would mean the child would benefit more from tubes than other children. Medical management is always the first line of treatment, but the option for tube placement deserves serious consideration if a patient has not improved with medications.
The surgery is actually very straightforward and takes approximately seven minutes. Because the child has to be very still, they do undergo general anesthesia. The procedure is performed under the microscope, and using magnification we make a tiny cut in the eardrum, remove the fluid and put in a small tube. The tubes remain in place for a varying amount of time, depending on how fast the child’s eardrum grows, but typically the tube is in place about nine months. During that time period, we expect that the child will have fewer and less severe ear infections, and less fluid build-up, meaning that hearing will be better, language acquisition will improve, and behavior and concentration skills will be enhanced.
In many children, you can see an almost immediate hearing improvement, noticeable even on the way home. It can take up to six months to see the impact of the tubes on the severity or frequency of ear infections, but the hearing improvement is almost immediate.
Every child deserves the absolute best possible care with the most experienced people who are thinking carefully about each decision. At Texas Children’s, we have a team approach for every single patient, and we definitely work together to try to assure we have the optimal outcome. The nursing and anesthetic care at the hospital is truly outstanding, and, as a physician, that gives me great confidence moving forward. I think it’s important that parents have confidence in the entire team working for the best health of their child.