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Ear Infections and Ear Tube Surgery
Ear InfectionsMany children, especially those between the ages of 6 months and 6 years, get middle ear infections (otitis media). Children who attend day care are particularly susceptible, while older children experience ear infections less frequently. Ear infections are relatively easy to treat. Most of the time if the ear is inflamed and painful, your child's doctor will prescribe medication - generally an antibiotic. If your child has had multiple, resistant ear infections that aren't getting better, or has evidence of hearing loss or speech delay, your doctor may suggest ear tube surgery (tympanostomy tubes).
Otitis MediaOtitis media is an inflammation of the middle ear. The middle ear is a grape-sized, air-filled cavity located behind the eardrum. When the eardrum vibrates, tiny bones in the middle ear also vibrate and transmit the sound signals to the inner ear, where nerves relay the signals to the brain. A small tubelike tunnel called the Eustachian tube serves to equalize the air pressure between the outside world and the middle ear. When your ears "pop" while yawning or swallowing, your Eustachian tubes are adjusting the air pressure in your middle ear. Bacteria and viruses can enter the middle ear through the Eustachian tube. The resulting infection, particularly if it is a bacterial infection, causes the middle ear to fill with fluid and sometimes pus. Pressure from this buildup pushes on the eardrum, causing pain. Because the eardrum cannot vibrate, your child may experience a temporary hearing loss. With treatment, a bacterial source of infection is stopped and your child's hearing is quickly restored. Without proper treatment, however, chronic ear infections can lead to long-term damage of the eardrum or the bones of the middle ear, and even permanent hearing impairment. Even temporary periods of hearing loss in young children can cause delays in speech development and learning.
Symptoms of Otitis MediaVery young children often cannot communicate well enough to tell you where it hurts. Many ear infections occur about 4 to 7 days after a child has had a cold. That's because Eustachian tubes can swell during a cold, blocking in bacteria and fluid. Look for the following symptoms:
See your child's doctor if you suspect that your child has an ear infection. He or she will examine your child's eardrums, and if the ears are presumed to be infected from bacteria, treatment will begin immediately. If your child does not have an ear infection but shows signs of a hearing problem, your child's doctor will then consider other sources of the hearing loss.
Treatment
Tympanostomy Tube SurgeryIf your child is old enough to understand what surgery is, you may want to prepare him or her for the visit by talking about what to expect. The following steps will be taken during ear tube surgery:
Your child will wake up in the recovery area. In most cases, the total time in the hospital is about 2 hours. Children under 3 months of age and children with chronic conditions such as heart or lung problems, or cerebral palsy, will often stay overnight.
Special Care After SurgeryTympanostomy tubes help prevent recurring ear infections by allowing air to ventilate the middle ear. Other substances, including water, may sometimes enter the middle ear through the tubes, and this is generally not a problem. Doctors now suggest that earplugs are not usually necessary for routine bathing or swimming. However, your child should avoid diving or putting her head under water in a soapy bathtub without using some form of earplugs. In most cases, there is no need for further surgery to remove a tympanostomy tube. The tube generally stays in the ear anywhere from 6 months to 2 years, depending on the type of tube used. It usually falls out on its own, pushed out by the eardrum itself as it heals. Sometimes surgical removal of tubes is needed if they remain in the eardrum past 2 years; this is done to prevent scarring, permanent damage to the eardrum, and tissue buildup around the tube. Although effective in reducing chronic ear infections, ear tubes are not a one-time permanent cure for otitis media. Up to 25% of children who need ear tubes before the age of 2 may need tubes again.
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Although ear tube surgery is a relatively common procedure, surgery is not the first choice of treatment for otitis media. Antibiotics are the most effective primary treatment for bacterial ear infections. If your child's infection fails to respond to several courses of antibiotics; if ear infections are chronic or recur frequently; or if there is evidence of hearing loss or speech delay, your child's doctor may suggest surgery to drain the fluid and insert ventilation tubes. These tiny tubes, also called pressure equalization (PE) or tympanostomy tubes, are inserted surgically into the eardrum, where they remain to allow for continual drainage of fluid and normalization of pressure in the ear space. After a short time, your child's hearing will return to normal. Tympanostomy tubes greatly reduce the occurrence of further ear infections.
