When is the right time for ear tube surgery in young children?

By Alicia S. Peller, M.D.

Most infants and younger children endure middle ear infections (otitis media) during the course of childhood, usually between the ages of 6 months and 2 years old. But why do some children suffer from them repeatedly? Most of the time, these youngsters are more susceptible because of environmental and lifestyle factorst daycare environments, exposure to secondhand smoke, and taking a bottle to bed.The good news is the majority of kids eventually outgrow this nagging condition beginning around age 5.

How does a child get an ear infection?

A small passage between the middle ear and back of the nose, called the eustachian tube, equalizes air pressure between the middle ear and the outside world. But when bacteria or viruses enter the middle ear through this canal, an infection can result. Children are especially susceptible to ear infections during a cold or upper respiratory illness.

When the middle ear becomes infected, it may fill with fluid or pus.

Pressure from this buildup pushes on the eardrum, resulting in significant pain. Since the eardrum cannot vibrate normally, the child may also experience a temporary decrease in hearing. Pediatric symptoms Physical signs of otitis media in infants and young children include:

 ongoing pulling or rubbing the ears

 fever

 fussiness or irritability

 fluid leaking from the ear

 changes in appetite or sleeping patterns

 trouble hearing

Chronic ear infection treatment options

Most of these infections are relatively easy to treat with antibiotics that are typically used to treat bacterial ear infections. However, many ear infections are viral and medication will not lessen symptoms.Viral ear infections need to improve on their own and, like any virus, only time and a healthy dose of patience can help them heal.

Children who have repeated infections that do not respond positively to medication or experience any degree of hearing loss may be candidates for ear tube surgery.This minor surgical procedure can offset future infections and protect the ear from permanent damage. Research also suggests that long periods of hearing loss in young children can lead to delays in speech development and learning.

During this outpatient procedure, which takes less than an hour to perform, a small tube is placed in the eardrum to ventilate the area behind it and keep the pressure equal to atmospheric pressure in the middle ear.Tubes are usually inserted in both ears for children who have sustained chronic infections, which will help prevent the accumulation of fluid, inhibit infections and stabilize hearing. Depending on the type used, the tube remains in place from six months to 18 months or more.

Most of us can remember suffering with this medical condition at some point in our lives mainly because the pain was so significant.As a pediatrician, my advice to parents and caregivers is to be keenly aware of ear infection symptoms and seek treatment promptly if you suspect your child may have this condition.

CentraState Medical Center’s Physician Finder offers a roster of board-certified pediatricians and other physician specialists. To find a doctor in your area, visit centrastate.com/physicians or call CentraState’s Physician Finder at 866-CENTRA7.

Dr. Peller is a board-certified pediatrician who can be reached at Allentown Medical Associates by calling (609) 758- 1100.