What to know about using ventilation tubes to battle ear infection

By M.J. Stevens, Special to The Sunday

Monday, June 20, 2016 | 2 a.m.

Despite parents’ best efforts, many children suffer repeated middle-ear infections, sometimes as many as five or six per year. The episodes can be uncomfortable for the child and, if left untreated, infections could permanently affect a child’s hearing and speech.

To prevent long-lasting effects on children whose ear infections keep coming back and aren’t cleared by antibiotics, doctors often recommend a surgical procedure commonly referred to as ear tubes. Here’s a look at what the procedure entails, its risks and its benefits.

When does a doctor recommend the procedure?

Most doctors consider ear tubes as an option if a child has had chronic ear fluid for four to six months, more than three ear infections in six months or more than five ear infections in a year, particularly if the infections cause hearing loss and/or affect speech development.

How does healthy ear drainage work?

Ventilation of the middle ear normally is done by the eustachian tubes, a pair of narrow passages that run from the middle ear to the pharynx, high in the back of the throat. The ends of the tubes closest to the throat open and close to regulate air pressure in the middle ear, circulate air and drain normal secretions from the ear.

Swelling, inflammation and mucus from an upper respiratory infection or allergy can block the passages, causing fluid to accumulate in the middle ear. Poor drainage is more common in children because their eustachian tubes are narrower and more horizontal, making them more difficult to drain and more likely to get clogged.

Are ear plugs needed for swimming/washing?

Not long ago, ear-tube surgery consigned a child to summers in the pool with heavy-duty earplugs and neoprene headbands. Not anymore. Although some doctors continue to recommend that children with ear tubes avoid getting water in their ears, most people in the medical community agree that swimming in clean water without ear plugs is safe for a child with tubes.

However, swimming in lakes, rivers, ponds or oceans still is not recommended without ear plugs, as murky waters can expose a child’s ear to bacteria, causing an ear infection. Ear plugs also are encouraged when diving or swimming deeper than 2 feet, as water pressure can force water through ear tubes into the middle ear.

How is the procedure done?

A doctor surgically inserts a ventilation tube — a tiny cylinder, usually made of plastic or metal — into the child’s eardrum to prevent fluid backup in the middle ear. The ear tube creates an airway that ventilates the middle ear and prevents the accumulation of fluids behind the eardrum.

How long do they last?

The most commonly used tubes stay in place for six to 12 months and require follow-up visits until they fall out. The holes typically close on their own. Some children may need a second surgery to place new tubes in the ear if ear infections return after the original tubes fall out.

Benefits

• Reduce the risk of future ear infections

• Restore hearing loss caused by middle ear fluid

• Improve speech and balance problems

• Improve behavior and/or sleep problems caused by chronic ear infections

Risks

Ear-tube placement is a relatively safe procedure with a low risk of serious complications. However, possible risks include:

• Bleeding and infection

• Persistent drainage of fluid

• Blocked tubes from blood, mucus or other secretions

• Scarring or weakening of the eardrum

• Tubes falling out too early or staying in too long (which may require surgery to remove or replace the tubes)

• Failure of eardrum to close after tubes fall out or are removed (which may require an operation to close the holes surgically)

• Surgery for ear-tube placement typically requires general anesthesia, which carries risks as well.