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Ear Tubes 101

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Does your child suffer from multiple ear infections? If repeated courses of medications haven’t worked, there is a simple operation that is highly effective at helping children who suffer from these repeated ailments: ear tubes.

What are ear tubes?

Ear tubes are tiny cylinders, usually made of plastic or metal, that are surgically inserted into the eardrum. An ear tube creates a passage way to ventilate the middle ear and prevents the buildup of fluid behind the ear drum.

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Why do children have ear tubes put in? There are a wide variety of reasons that children receive ear tubes. The child’s language, speech and various elements of their intellectual development, will impact the decision of who will benefit from tube surgery. The basic national guidelines for tube placement include children who have:

  • Ear fluid that persists behind the ear drum for 3-6 months
  • More than 6 infections in one year
  • Greater than 30 db conductive hearing loss in either ear
  • Speech, language or learning delay
  • Other special circumstances (including 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.

What age do children normally have eat tubes put in? 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 and is rare after the age of 8-10 years.

What does the surgery entail? The surgery is very straightforward and takes approximately 5-10 minutes. Because children have to be very still, they will undergo general anesthesia with anesthesia air via a mask. The procedure is performed under a microscope. Using magnification, doctors 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 for about 9-15 months. During that time period, we expect the child will have fewer and less severe ear infections and less fluid build-up. These improvements should mean their hearing will be better, their language acquisition may improve and their behavior and concentration skills may be enhanced.

In many children, you can see an almost immediate hearing improvement. It can take up to 6 months to see the impact of the tubes on the severity or frequency of ear infections. With ear tubes, an ear infection will manifest with ear drainage that can easily be treated with antibiotic ear drops.

To learn more about otolaryngology at Texas Children’s, please visit the otolaryngology website.

Dr. Ronald Vilela, otolaryngology surgeon