Nearly every child will have at least one ear infection, and about 30-40% of children have recurrent ear infections.
For those children who have many, many ear infections, the choice of whether to place tubes in the eardrums to improve drainage and cut down on the number of ear infections is an option that frequently comes up.
In the February 2014 issue of Pediatrics, the question of how the tubes work was reviewed. Over 40 research papers that did a quality job of assessing what the tubes do and do not do were reviewed.
Several themes emerged from this comprehensive review.
Placing tubes in the eardrums does reduce the number of ear infections a child has
The studies were in agreement that if you have tubes in your eardrums, you will have fewer infections.
This supports what we consider the best reason to place these tubes: if the pain of constant or recurring ear infections is too much to bear, ear tubes will help and make sense to have.
Placing tubes in the eardrums has no impact on a child's development of language, cognitive, or academic skills.
Much has been made of the fact that while you have an ear infection, or even just fluid in the ear, your hearing is not as good. This of course makes sense, put your thumbs in your ears and your hearing gets dramatically worse. The question is, if your hearing is reduced for a few months or years in early childhood, will that have an impact on your language development? It is well known that when the ear infection heals and the fluid clears, hearing returns to normal, so the impact of infection or fluid in the ear is always temporary.
What this careful review found was if you took a group of kids with lots of ear infections or fluid and some got tubes and some did not, there was no difference in the cognitive, language, or academic function of the two groups over time.
So yes, if you have lots of fluid in your ears when quite young, you may not learn as many words as someone without fluid, at the time the fluid is present. But if you check in some years later, well after the fluid has dried up, say around 7-10 years of age or beyond, the vocabulary, language level, cognitive level, and academic performance level is the same whether you had fluid or not.
This finding supports the notion that the impact of lower hearing while fluid is present disappears once the fluid clears.
Placement of tubes in the eardrums increases the chance that there will be drainage and/or scarring in the ears
The studies also found that kids who got tubes in the eardrums experienced an increase chance of draining fluid from the ear and later on, of scarring on the drum.
- Ear infections are a very common event in childhood, and many children get many of them.
- Placing tubes in the ears can offer real relief from very frequent, painful ear infections.
- Placing tubes in the ears may offer no change in ultimate levels of language, cognitive, or academic performance
- Placing tubes in the ears does increase the chance of scarring of the eardrum and drainage from it.
- Our recommendation is to place tubes in the ears mainly for relief of excessive and relentless pain, not simply in response to a certain number of ear infections.
Dr. Arthur Lavin
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