What are ear tubes and how will they help my child?

If your child has recurring ear infections or fluid in the middle ear, ear tubes may be the answer.

Yikes! If you’re anything like me you are thinking—“Oh no, not ANOTHER surgery! Will it be painful? Does my child really need these? Can she take a bath or go swimming? And what the heck are they, anyway?”

Well, after doing a bit of research, my nerves were calmed somewhat—hopefully yours will be, too. Here’s what I found:

Does my child with Down syndrome need ear tubes?

Our little angels tend to have smaller ear canals and Eustachian tubes and are more sensitive to ear infections, as well as colds and sinus infections. Usually, ear infections go away by themselves or are treated with antibiotics.

Sometimes, though, chronic ear infections and fluid in the middle ear (or glue ear) can lead to other things like hearing loss, speech issues, and trouble with behavior.

If your child has hearing loss, it’s a problem. (Most times, unless there’s permanent damage, hearing comes back after the fluid is drained.) If your baby can’t hear you properly, he can’t understand your speech clearly. Our kids have enough trouble with speech. They need to be able to understand vocal sounds clearly so they can have the best chance of speaking clearly.

If they can’t hear you, sometimes they withdraw into themselves. The world around them sounds muted and fuzzy. Imagine someone trying to say something—anything—to you when you are wearing earplugs with earmuffs over them. It kinds sounds like Mmmhhh? Sssshhm mwwww aahh llllllloouu?

You would simply stare at them blankly and then turn away.

Bottom line—if your child has chronic ear infections or fluid in the middle ear leading to hearing loss, they probably need ear tubes.

OK, so what are they?

Ear tubes are just that: short, tiny tubes. They have to be tiny—just look at a child’s ear! They are placed through the ear drum to allow fluid drainage (more about this later). They can be made of plastic or metal. Some tubes have a special antibacterial coating to help prevent infection.

Usually tubes are placed for six months to a year. These end up falling out by themselves as your child grows. There are longer term tubes—these look pretty much the same as the short term ones, except there is a little lip on both ends called a flange. The flange makes the tubes stay in longer and will have to be removed at the end of treatment.

The Surgery

I couldn’t imagine actually working inside my little girl’s ear because it’s soooo tiny and dark in there, but doctors have special tools and lights to get the job done. First of all, this surgery is VERY SAFE. It’s been around since 1954. It’s one of the most common surgeries done on children.

There is a slight controversy about whether ear tubes should be routinely used. However, despite the disagreement, The American Academy of Pediatrics clinical guidelines say that a child who is “at risk for speech, language, or learning problems because of other conditions including Down syndrome” should not wait to have tubes placed.

But How Do They Do It?

Gosh, after reading about this it seems so easy I could almost do it myself. Of course there IS that pesky medical degree…OK, yeah, maybe we should leave it to the experts.

First, your child will get some type of anesthesia, usually nitrous oxide, or laughing gas. Then, using a surgical microscope and a tiny knife called a scalpel, a hole or incision is made through the ear drum.

The problem fluid is suctioned out and the tubes are inserted into the tiny hole. Eardrops are put in to prevent infection. The whole procedure is done within 15 minutes.

See? Easy peasy. Oh, and get this. If tubes aren’t inserted right then, the hole closes up in a few days by itself! Ha! Sounds an awful lot like getting your ears pierced, doesn’t it? Some enterprising person could set up an ear tube insertion clinic right in the mall next to the manicurist!

After surgery

Typically if there are no complications, your child will be able to go home in about an hour. There is little to no pain. Your child might experience grogginess or be irritable, and might throw up from the anesthesia.

Hearing comes back right away after the fluid is removed. In fact sometimes the kids complain that normal noises are too loud now! That corrects itself quickly, however.

It’s important to follow all post-operative instructions! They will tell you when to come back for a follow-up appointment, what to do if the tubes fall out, and what to watch out for when observing your child’s ears. Sometimes your child will be prescribed antibiotic ear drops for a few days after surgery.

What About Baths or Swimming?

Some physicians will tell you to have your child wear earplugs anytime they get into water. (If you are anything like me, you are thinking what a joke that is. Do they even make earplugs small enough?)

Thankfully, new research has shown that earplugs might not be needed except when swimming in lakes or rivers (non-chlorinated waters). ALWAYS ASK your physician what they think is best for your child’s situation.

Complications

Alright, perhaps the surgery isn’t as easy as getting your ears pierced. There’s that tiny opening to deal with. And there are some complications and risks of surgery. They are:

• Falling out too soon—If they do come out too soon (and sometimes this happens) your child may have to have another ear tube placement surgery.
• Staying in too long—This can cause what’s called a perforation (see below). If they are not falling out on their own then the tubes will have to be removed which means another surgery.
• Perforation—this means when a tube either comes out or is taken out the hole in the eardrum does not close. This can be corrected with -you guessed it- another surgery.
• Scarring—I’m not sure why this is a complication because in most cases there is no problem with hearing. I suppose physicians want to keep us informed of all the risks.
• Infection—Ear infections are still a possibility, even with the ear tubes placed. Usually, though, they are much less severe and easier to treat with eardrops or antibiotics.
• Blockage of ear tube--This will cause fluid build up again leading to the same problem as before.
• Pus Discharge--What more can I say about this?

Don't be scared. Complications are rare!

from ear tubes to home