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By: Dr. Ryan Dempewolf
Ear infections are an all-too familiar part of modern parenting. Ear infections are one of the most common reasons for kids to go to the doctor – annually, they account for almost 30 million trips to the office in the U.S.
This is the time of year that many parents see their ear, nose and throat specialists, either directly or on referral from their primary care physician, to get their kids some relief from ear infections. Allergies, viruses and potentially adenoid issues are the main culprits causing recurring ear infections. Sometimes, infections and fluid in the ears can become a chronic problem, leading to recurrent use of antibiotics and even temporary hearing issues. That’s when it’s time to consider ear tubes.
The middle ear is a small space behind the ear drum that is supposed to be well-ventilated by air that passes up from behind the nose, through the Eustachian tube. When there is not enough air ventilating the middle ear, such as when the Eustachian tube does not function well, the area becomes damp, stagnant and warm.
In children and infants, the Eustachian tube is often not in the correct anatomic orientation to function well. This changes as kids grow, and most will simply outgrow their ear infection issues. Swelling from a cold or allergies can also inhibit the Eustachian tube’s ability to allow air into the middle ear. Bacteria can quickly invade the warm, moist environment.
Children who are diagnosed as having chronic or recurring ear infections, or who have hearing loss or speech problems due to fluid in the ears, are recommended to get ear tubes to drain and restore the middle ear to normal.
Ear tubes are tiny cylinders placed through an incision in the ear drum, called a myringotomy. The tubes reopen and replace the function of the Eustachian tube temporarily, eliminating the fluid build-up and pain.
Children are given 3-5 minutes of general anesthetic for this procedure. After the myringotomy, the fluid is suctioned out and an ear tube placed in the hole. This is most often done under a surgical microscope with a small scalpel.
Ear drops may be administered after the ear tube is placed and are sometimes prescribed for a few days. The procedure usually lasts less than 5 minutes and patients awaken and recover quickly.
The biggest advantage to ear tubes is the reduced use of oral antibiotics. Children with tubes usually get far fewer infections, but can still get infections. If they do, the infections show themselves as visible drainage from the ears. Should your child get an ear infection with tubes in, your otolaryngologist will prescribe antibiotic drops to treat it.
If your child has had tubes placed two or three times, your otolaryngologist might recommend removal of the adenoids. Current research does not indicate a strong relationship between adenoid tissue and ear infections, but if we have to put in multiple sets of tubes, it may be worth trying so that hopefully we do not have to repeat the surgery again.
For more information about ear, nose and throat specialists at Physicians’ Clinic of Iowa, please see www.pcofiowa.com/ent or call 319-399-2022.