Ear infections are common among kids, and often painful. Ear infections happen when viruses or bacteria get into the middle ear, the space behind the ear drum, causing pressure and discomfort.
ENT specialist Gerard O’Halloran, MD, explains:
What causes an ear infection?
The most common type of ear infection is otitis media, an infection in the space behind the eardrum. where the little chain of bones most of us learn about in high school are, the hammer, anvil, stirrup. That room or space is normally filled with air; if there isn’t enough air flowing through, it develops a vacuum that pulls fluid from the surrounding tissue. Bacteria grows in that trapped fluid and causes an ear infection.
Babies and young kids are especially vulnerable because their Eustachian tubes – the path for air flow into the inner ear – are small and gets blocked easily, especially if they have large adenoids, have a cold, or are exposed to secondhand smoke.
How do you treat ear infections?
Most ear infections are treated with antibiotics, through your pediatrician or family doctor. For kids who have lots of repeated ear infections or their hearing is affected, ventilation tubes may help. Tubes are also an option if antibiotics have stopped working or are causing complications like diarrhea or chronic diaper rash. We also see children for speech delays and one of the first things we do is check their hearing and look in their ears. If they’re significantly blocked, ear tubes may help.
When should ear tubes be considered?
There are very specific guidelines for putting in ear tubes, which requires surgery.
We’ll consider putting ear tubes in for children who:
- have had three or more infections in the last six months
- have complications from antibiotic treatments
- are no longer responding to antibiotic treatment
- have had their hearing affected for an extended period of time
- have trouble with learning, speech and language development
- have special needs or disabilities where we want to optimize their hearing for them
How do ear tubes work?
They’re surgically placed in the eardrum. The child is put to sleep and a small nick is made in the eardrum; if any fluid it present, it’s vacuumed out and the tubes are inserted in the eardrum. Surgery takes about four minutes, and kids are typically ready to go home about an hour later.
The tube looks like a little spool with a hole in the middle. It sits in the eardrum to keep a small hole open to let air flow in from the outside, because air isn’t flowing to the inner ear through the Eustachian tube. The tube is designed to naturally fall out of the eardrum as the child grows.
Tubes generally will decrease the number of infections dramatically. Having one or two infections after ear tubes go in is relatively common. I place between 100 and 150 sets of ear tubes each year; only one or two patients continue to have trouble. Even for these kids, the tubes let their ears drain and make any ear infections easier with antibiotic drops, which have fewer side effects than oral antibiotics.
Ear tubes almost always restore hearing to normal, and they tend to head off permanent damage or hearing loss.
Another benefit is that kids with ear tubes don’t have trouble flying. The tubes equalize the pressure on their ears during takeoff and landing.
What are the drawbacks of ear tubes?
There are three concerns to address when considering ear tubes:
- They’re expensive.
- Tubes require a general anesthetic. We use a mask anesthetic, so it’s a simple procedure and it’s brief. We let the parents be there while their child falls asleep.
- There’s a small risk that when the tube naturally falls out of the eardrum, it will leave a hole in the eardrum. This can be fixed with surgery.
That’s why we follow guidelines to ensure kids can really benefit from ear tubes – to solve chronic ear infections or other problems – before considering tubes.
ENT specialist Gerard O’Halloran, MD sees patients in Northfield, Faribault and Lakeville Clinics. Visit our ENT page to learn more, and schedule your appointment.