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Is Child Ear Tube Surgery Really Necessary?

20 March 2009 9,321 views No Comment

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Middle ear infections (acute otits media or sometimes called “glue ear”) are very common with children between age 6 months to 3 years old. They are the 2nd most common childhood illness, and the leading cause of surgery (bilateral myringotomy) for young children in the US.  The root cause of infections are most typically a diet high in dairy or wheat, congestion from allergies or colds and exposure to second hand smoke. About 1 in 10 pre-school children experience middle ear infections at some time.

Ear tube surgery is typically recommended by doctors (but not by most naturopaths) after a period of 3 to 4 months of chronic ear infections or significant hearing loss.  Getting your child’s hearing professionally tested is always a good idea as a starting point.  If nothing else, it gives you a benchmark to monitor if hearing is getting better or worse as the child ages.

If you consult a doctor, they will often refer you to an audiologist for a series of hearing tests over 1 to 3 months.  If hearing is poor or declining, they will often prescribe surgery.  Studies have shown, however, that up to 80% of ear surgeries were not necessary.  As of 2004, doctors are now no longer prescribing taking out a child’s tonsils as a remedy for colds.  Medical advice changes over time, and this factor should be considered before you jump to surgery. Research shows that 50% of children suffered at least minor complications after ear surgery, including a small amount hearing loss, tubes falling out and having to be re-inserted as well as continuing infection.

Will Hearing Loss Delay Child Development?

A study published in The New England Journal of Medicine says waiting to see if the infections go away on their own won’t hurt your child’s development and could spare them from going under the knife.
Researchers at Children’s Hospital of Pittsburgh say there’s no harm in waiting to see if the infections go away before deciding to subject your child to surgery.

child-ear-surgeryIn the study, researchers followed 429 infants who had persistent middle ear infections. The subjects were randomly assigned to either promptly undergo ear tube surgery or to wait six months if they had fluid build-up in two ears or nine months if they had fluid in one ear. By the end of the study period, 113 out of 213 of the children assigned to the delayed surgery group had not required ear tube surgery.

At the age of six, 395 of the children underwent a battery of tests, assessing their intelligence, vocabulary, and behaviour at school and at home. After accounting for maternal level of education, gender differences, and other factors, the researchers found no significant difference in speech or learning development between the children who underwent ear tube surgery and those who did not.

Prevention Of Ear Infections

1) Breastfeeding

Breastmilk contains antibodies that help protect a baby from many infections, including those that can cause ear infections.

2) Reduce Exposure Secondhand Smoke

Smoke appears to increase the risk of ear, as well as respiratory, infections. Minimizing dust in the home also may help.

3) Avoid Colds/Viruses

Easier said than done with playgroups, difficulty in handwashing for young children etc..

Treatment of Ear Infections

1) Change Diet

A naturopath will simply recommend removing wheat or dairy from your child’s diet.

2) Antibiotics

Are often used to treat bacterial ear infections but many ear infections are viral and cannot be treated with antibiotics.

3) Middle Ear Air Ventilation

Products such as the Ear Popper (bad name, but great product even if over-priced for what it is at $200 Cdn+) are non-invasive, and work 75% of the time to stop ear infections.  It simply works by blowing air up the nose and into the middle ear via the eustachian tube (plug one nostril, and have your child drink while you blow a small amount of air up the other).

Risks of Ear Tube Surgery

1) General Anesthesia

Your child will need to be completely put under with a general anesthetic.

2) Long Term Hearing Loss

Studies have shown an average of 2 to 4 Decibel drop in hearing following a surgery.  When the middle ear drum is cut, it heals (closes) 98% of the time, however, scar tissue builds up where the incision was made.

Written By: Chris Charlwood




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