Does your child need ear tubes?

Rahul Kataria, MD

Pediatrics

While it’s common for a child to have an occasional ear infection, problems can arise when the infection keeps coming back or when antibiotics don’t seem to help it fully resolve. In that case, ear tubes might be able to provide your child the relief you’ve been searching for.

Pediatric physician Rahul Kataria, MD, explained what ear tubes are, how they’re used and what to expect after your child receives them.

When are ear tubes helpful for children?

“If a child struggles with chronic or recurring ear infections, it not only affects their hearing but can also impact speech development,” said Dr. Kataria.

For that reason, a pediatrician or an ear, nose and throat (ENT) specialist may recommend ear tubes as a solution to those who meet certain criteria:

• The child has had multiple ear infections (at least four or more within six months)
• They have struggled with recurring ear infections for years
• The child has had fluid behind the eardrum consistently for more than three months

Generally, this recommendation comes after assessing the child’s speech development and any impact had by the recurring infections.

What does an ear tube procedure involve?

Ear tube placement – also called myringotomy – involves an ENT surgeon who places tubes into the child’s ear. This might be done to one single ear, if the problem is localized on one side, but usually tubes are put into both ears at the same time.

“This is a fairly simple procedure,” Dr. Kataria said, “designed to regulate the pressure within the affected ear or ears by promoting drainage and proper airflow.” When done to both ears, the procedure is referred to as a bilateral tympanostomy.

Before the tubes can be placed, the child will first be put under general anesthesia. When the anesthesia has taken full effect, the surgeon will make tiny holes in the child’s eardrums so they can remove any trapped fluid found inside.

Next, the surgeon threads the tubes through those premade holes, carefully placing them to ensure fluid can’t build up again to create future problems.

Ideally, the outpatient procedure takes about 15 minutes, with the process from start to finish taking just a few hours. Once the child has woken from anesthesia, their parents can usually take them home to recover.

What should I expect after my child receives ear tubes?

Antibiotic ear drops are usually prescribed for three to five days after surgery, and there might be some noticeable drainage within that time. After that, you and your child simply go about life as normal.

“Ear tubes usually last from six to 18 months,” said Dr. Kataria. “After that, a child’s body will make the tubes fall out on their own. In some cases, tubes must be manually removed, but those cases aren’t common.”

Successfully placed ear tubes will offer a way for fluid to drain out of the middle ear safely and normally through the ear canal from then on, even after they fall out, and family members, friends and teachers should notice an improvement in the child’s speech development and ability to hear.

Follow-up appointments with the surgeon will take place about every six months until the tubes fall out on their own.

What if my child gets another ear infection after receiving ear tubes?

“Children who have more ear infections post-surgery will usually show yellow, green or white ear discharge,” said Dr. Kataria. “In that case, we prescribe an antibiotic eardrop for a minimum of seven days, and it’s important that your child takes the entire course of antibiotics even if they seem to improve quickly.”

If drainage doesn’t improve with the use of ear drops by the third day on antibiotics, the child will need to be seen by a physician again.