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Ear Tubes and Hearing
As many as 700,000 children each year in the United States have ear tubes placed surgically to treat chronic and recurrent fluid behind the ear drum (otitis media with effusion, or OME). A study in the December 2005 Archives of Pediatrics and Adolescent Medicine argues that young kids who get tubes are more likely to have some hearing loss 6 to 9 years later than are matched kids who did not get the tubes. To me, this study underlines the importance of only placing tubes in kids who need them – but it is not a cause for alarm or for change in the May 2004 joint guidelines concerning which children benefit from tubes. This study looked at 125 children who had tubes placed (or not) between 1985 and 1989, when most of the tubes themselves were different (harsher) than today’s bobbin-type tubes, and the recommendations for placing them were less conservative. The children in the study had already had fluid present in the ear for at least 3 months. Half of the children in the study were randomly assigned to get tubes and the other half were randomly assigned to get 6 months of antibiotics (common in the 1980’s). Those who were assigned to get tubes in the study had a mild average hearing loss (28.7 decibel threshold) before the tubes were placed (today we recommend tubes in otherwise healthy children when fluid has been present for at least 3 months and the hearing loss is moderate -- >40 decibel threshold – a level of hearing loss we know can affect speech, language, and academic performance if allowed to persist). Years afterwards, those in the tube group had hearing that averaged 2 to 8 decibels worse at some frequencies than did their peers in the antibiotic group (although more than half the kids in the antibiotic group were eliminated from consideration, because they ended up getting tubes anyway). Tubes do carry with them measurable costs and risks. The key is to reserve them for those children where the benefits are likely to far outweigh the costs.
Alan Greene MD FAAP
December 19, 2005 | Permalink
Comments
My grandson just had his adenoids removed and tubes put in both ears because of fluid in his ears and sleep apnea. He is 3 years old. He also had a speech defect, with the s sound and p sound. He just got it done yesterday, and while his tslking is quieter and his snoring stopped, his speech overall seems worse. Is this normal?...and will it go away with time?
Worried grandam
Posted by: Darelynn | Jun 25, 2008 5:47:53 AM
My daughter is 3 1/2 and the ENT says that she needs tubes in her ears because this past winter she had about 5 ear infections and has fluid in both ears now...although she just finished antibiotics a week ago for an ear infection and it may have not cleared yet. Anyway I ordered a hearing test and her hearing is normal but the doctor still insists that tubes be put in....any advice...I wanna do the right thing by my daughter????
Posted by: Elisha | Jun 22, 2008 2:06:11 PM
About three years ago my 5 yr old son had a complete tonsilectomy and tubes put in his ears to correct constant tonsilitis and ear infections. After the surgery, he did very well. It was like he was a new child. But in the last year my son started complaining about frequent headaches, dizzy spells, and stomach problems (nausea,sour stomach etc). Our Dr recommended we see a gatroenteroligists. Long story short after many tests (MRI, endoscopic surgery) they have found that he has inflammation in his stomach. But the MRI has found a problem in his inner ear (which would explain the dizzy spells/headaches). My son is now scheduled to have a high tech MRI screening to see what exactly is going on in the ear. I been researching on inner ear disorders and cannot find anything about possible side affects associated with tubes put into the ears. Does this sound familiar to anyone?
Posted by: Ruby | May 11, 2008 9:01:00 AM
I am so confused after reading all of these comments!! My 12 month old son has had 6 ear infections starting at age 3 months. He has trouble sleeping, crying in pain, sinus infections and has been on amoxicillan, augmentin, 2 rocefin shots and now Ceftin with some strange eyedrops to put in his nose. My regular doctor doesn't believe in placing tubes in but a second doctor (in the same practice) advised us to see an ENT. I did today and the ENT said he needs tubes and that he has fluid in his left ear. We are to have his hearing tested tomorrow. I really do not know what to do...I do not want him to suffer or have hearing loss but what I have read that happens later in life quite frankly scares the hell out of me.
Posted by: anne | Apr 21, 2008 7:06:13 PM
my pedes dr sent us to an ent after my 18 month old had 7 ruptures and 10 double ear infections in 4 months. within 24 hrs of tube placement she spoke 4 new words and hasnt stopped yet. before the surgery she could only say mamma. and she has had no more ear infections. i would do if again.
Posted by: kris h | Feb 28, 2008 5:36:36 PM
My son is 16 months old. We just visited the E.N.T. and he suggested bilateral ear tube placement. I have many concerns about this procedure as I fear for future ear infections (if they will be worse?), fear of bath water entering his ears, fear of scar tissue build up after the surgery causing hearing damage. But I also consider if the ear tubes are not placed will the scar tissue build up of repetitive ear infections affect his hearing?
Posted by: | Feb 8, 2008 11:39:15 AM
My son had tubes put in both of his ears at 13 months old after only one ear infection that did not clear up. He is now 6 years old and suffers from speech problems and is in intensive speech therapy. I noticed the hearing problem around his second birthday, carried him to his pediatrician who completly ignored me and said that his ears were fine and the tubes had came out on their own. I know this was not right, I am not a doctor, I have never been to medical school but I knew something was wrong with my child. When I took him to see the ENT who put the tubes in he refused to see my son. I finally found a doctor who would listen to me and he did a thorough exam and hearing test. I think believe should know the rishks of this procedure, it is not always just a matter of whether or not the infections will continue but what can happen after the tubes. We have hope for our son, he is improving greatly in his speech and we feel he will catch up with his peers. I have refused to let any of my other children get tubes and often times treat ear infections without antibiotics, my other children are doing good, their ears look great and their speech is where is should be.
Posted by: amy | Nov 6, 2007 7:24:05 AM
My daughter is 8 months old, and she has had 3 ear infections. The last one, about a month ago, was resistant to the antibiotic. The doctor gave her a shot of a different antibiotic and said that if she didn't respond, she would have to get tubes placed and keep them in for a year. She did respond to the second antibiotic, but now she has fluid behind her ear. The doctor is now trying a steroid to see if that will help. I am worried that if I wait to have tubes placed (if the doctor says she needs them), will it effect her hearing??
She has never shown signs of discomfort even if she has been diagnosed with an ear infection. She has only been reluctant with anything getting close to her mouth. She has one tooth already, and I know that more are coming. So, should I wait on tubes until I know its not her teething issue and see if the fluid drains on its own??
Posted by: Carrie | Oct 24, 2007 1:30:28 PM
Chiropractic maintenance has help my daughter with ear infections. last year she ended up with sever ear infections 4 times, each requiring multiple antibiotic treatments. Each time they only ended after I had her adjusted by a chiro. My regular pediatrician then recommended that I put her on monthly maintenance with a chiro. I have done this. She has not had an ear infection in over a year. Also, the chiropracter recommended garlic/olive oil drops. These are given to my daughter anytime she says her ear hurts. Usually two drops one time is all she needs.
My son, unfortunately, has not responded in the same way. He will be seeing an ENT shortly to discuss tubes and adenoid removal.
Posted by: kerri | Oct 7, 2007 8:37:16 PM
After reading this article, and many others which warned against unnecessary ear tubes, I was very reluctant to have tubes placed in my daughter's ears. She had many ear infections in the first 18 months of life. During this period, I also resisted antibiotics, but gave in a couple of times when a fever followed a cold and ear infection.
At 18 months, she stopped saying words she used to say. We were referred to an ENT, and he tested her ear drums. There was so much fluid behind them that the eardrum, that the meter testing for vibrations measured flat. Because I was reluctant to proceed, we waited two months, and her condition remained the same. Yet, I was still reluctuant and we waited another two months.
Her speech did not improve, and, after a short plane trip, she again got a nasty ear infection. It was on that trip that I met a woman who herself had the water behind the ear condition. She had just undergone the ear tube procedure. She indicated that the water behind the ear was irritating and made it almost impossible to hear (at least she only had it in one ear). She also told me that flying was very painful with the condition. Lastly, she was awake during the procedure and told me that the minute the ear drum was punctured, she felt relief from the pain. It was absolutely wonderful to get to talk to an adult about the possible pain and impact of the condition. I didn't have to rely on the contradictory web blogs or simply our doctor's recommendation.
We decided to go ahead with the procedure. The surgery literally was over in under 15 minutes. My daughter has completely recovered. She just had a four month recheck and the tubes are in place, her ear drums are healthy, and she has had no complications. Also, she has had NO EAR INFECTIONS (amazing considering they were regular occurrences before the surgery) and she is TALKING UP A STORM.
I have absolutely no regrets about having the surgery done. I only wish that there were more positive comments about the procedure on line for worry wart parents like myself. We may have done the surgery earlier and saved my daughter unnecessary pain and the further delay in her speech development.
Good luck figuring out what to do with your children.
A satisfied mom.
Posted by: Lauretta K | Sep 27, 2007 12:46:31 PM
my son is 5 and has had 5 sets of tubes now the drs tell us he will have up to a 25% loss in each ear as long as the tubes are open he can hear fine but if they are out or clogged he can only hear 15% and has a hare time hearing the middle tones (mainly speaking tones)
Posted by: aj | Sep 27, 2007 9:31:41 AM
My son is 5 months old and so far has had 5 ear infections in both ears! This last round the doctor said it was the worst he has seen in someone my son's age. We are meeting with and ENT to discuss the possibility of tubes. Have you heard of a baby getting tubes this young? If so, do you think it will be successful?
Posted by: Kathryn | Sep 8, 2007 8:54:25 PM
My son is 21 months old. He has had about 10 ear infections since he was 5 months old. He had his first set of tubes put in when he was about 1 and about three weeks ago he had his second set put in. The second set had to be placed because the first set of tubes shifted in his ear and began to irritate the inner ear. He still gets constant ear infections and his ears are continuously draining. We live on Floxin drops like they are water and he has tried at least 6 different antibiotics. He has a slightly hard time hearing high pitched sounds but is doing well with speech. I am concerened that the tubes are not helping reduce the number of ear infections and I dislike the idea of pumping him full of meds. Since the tubes, he is rarely uncomfortable due to ear infections, since the tubes relieve pressure. I have mixed feelings about ear tubes. I have a feeling they are not for everyone!
Posted by: Jessica | Jul 7, 2007 6:12:16 PM
My son had a set of tubes in his ears at about 18 months old, though the ear infections are not often as often, but when he does have one it's painful, he has liquid coming out and sometimes blood. I am worried about hearing loss. He is noe 2 years old and I know how important his hearing is at this age. Right now he is getting ear drops, I need to know all the possible side effects of the ear tubes.
thanks
Posted by: Nick | Mar 21, 2007 2:09:49 PM
Hello, I am a worrie wart mom.My daughter is almost 2 we have a month and a 1/2. Since she was born we keep being treated for ear infections the 1st was 3 months long,she was almost 6 months old. the second lasted 2 monthes she was a little over 1. this last one has been going on 1month and 1/2. I just took her to an e.n.t. They told me she has fluid in har ears (both).It is clear but she needs tubes to help it drain.And that she has lost 50 pecent of her hearing.I do not know if this will help or not. Has anyone tried an ear candle?Do you think this could help?
Posted by: tabatha | Jan 16, 2007 12:18:14 PM
I had my tonsils and adenoids removed and tubes put in my ears at age 12. I had what they called "marked hearing loss". That has been about 15 years ago. I've had chronic ear problems over the last year or so. I now have "glue ear" I think. It started about 2 weeks ago. I got a cold and went completely deaf in my right ear. I've heard there isn't much you can do about it. Is that true?
Posted by: Ronnie | Dec 1, 2006 1:06:45 PM
My daughter is 3 years old and in December 2005 had tubes put in. Hers were put in due to hearing loss caused from ear infections. It is now August 2006 and i recently took her in because her ear was bleeding from the inside. While at the doctors, I founf out that her tube in the other ear was also clogged. I am now putting drops, Floxin OTIC, in her ears to see if they improve.
My youngest is 8 months old and has had 3 ear infections. They ocurred at 4, 6, and 8 months. He has been on 3 different types of antibiotics, amoxicilan, augmentin and now Omnicef. I am wondering if his ears are not being completly healed with the antibiotics?
Should I be worried more then I am? What causes the bleeding from in the ear canal and around the tube? Is there anything more I can do? What things can I do to prevent anything more with both of my children.
Emily
August 24, 2006
Posted by: Emily | Aug 24, 2006 7:47:51 PM
My daugter, now 24, got ear tubes as a 2 month old infant. She had a retropharnageal abscess and the doctor assumed it was from ears and did it during surgery without our permission. Our daugter through life has never had any ear infections. Her troubles consist of not being able to travel over hills/mountains without her ears hurting, her left ear has trouble hearing, and her right ear has recently developed PET/autophony, a very annoying condition. I believe all this can be blamed because she had ear tubes as an infant, due to scarring... I have not found any information or anyone else who has aligned these similar troubles from ear tubes. Anyone have similar results? Dr. Greene can you comment also?
Posted by: Pat | Dec 31, 2005 10:58:15 PM
My son, now 9 years old, has had four sets of tubes from age 6 months to 3 years old. I just recently had his hearing tested to be sure he had no hearing loss from his surgeries. His hearing was normal with slight hearing loss in one ear which was due to fluid behind his ear drum. Hopefully, we can clear this up without further surgery and his hearing will be completely normal.
Posted by: Amber | Dec 23, 2005 6:16:51 PM
I have had a great deal of experience with ear tubes as all three of my children have had them placed. My middle child who is now 3 has had 2 sets and also his adenoids out to try and control the ear infections. In his case he did not have much of a hearing problem at all - just repetitive ear infections. After 36 courses of antibiotics in his first year of life we resorted to tubes and he has normal healthy eardrums now with no effect to his speech. My youngest however has had tubes in, and then surgically removed due to complications and we are considering a hearing aid to improve his hearing loss as he is severly speech delayed. In my experience ear tubes can be hugely beneficial but can also do more harm then good if risks are not correctly informed and weighed up. Thank you again for an informative article Dr Greene!
Posted by: Gertie | Dec 19, 2005 12:37:37 PM
My son is on his second set of tubes. His first were put in when he was 2, the second set when he was 4. In our case, it was a wonderful choice. He had chronic ear infections since about 6 months old, and we noticed hearing problems and speach delays until the first set of tubes. What a difference! He could hear! He could begin to speak clearly, and caught up with his peers. When the first set fell out, the ear infections came again, like clockwork, so we decided with the second surgery. He has not had an infection since, and it has been a year. It's been a good experience for us.
Posted by: Shannon | Dec 19, 2005 11:40:19 AM
