Pediatrics: Lillian Beard, M.D.
My one-year-old son has had three ear infections within a short time span and his pediatrician says we may need to consider ear tubes at some point in the near future. Is this his only option? Is the surgery risky? How long will he have to wear them?
By Lillian Beard, M.D.
Middle ear infections (otitis media) occur with some frequency in young children. One big reason is due to the anatomy of little ears. Unlike adults, the space between an infant or toddlers ear drum and the back of their nose and throat is fairly close. This allows the easy passage of secretions from feeding, teething, and the nose through the Eustachian tube into the middle ear cavity. Once trapped in this middle ear space, infection and discomfort may follow. Frequent ear infections can result in hearing loss, delayed speech development, and repeated doctor visits.
Tubes that are surgically inserted into the ear drum allow for the escape of these secretions, which helps prevent infection. The procedure is usually done in a hospital, or a surgi-center, under general anesthesia, but the child is allowed to go home on the same day. The tubes are designed to stay in place for many months and then dislodge spontaneously when the structure of the maturing ear changes.
Other options for dealing with chronic ear infections include repeated limited courses of antibiotics as middle ear infections recur or a single daily dose of an antibiotic for several months as a mode of prevention. Also, many childcare experts feel that immunization with the new pneumococcal vaccine, Prevnar, will provide protection against one of the most common bacterial bugs, which causes middle ear infections.
As children grow, the anatomy of the inside of the ear changes slightly. The passageway between the middle ear and the nose (Eustachian tube) becomes less direct, wider, more curved, and a less likely reservoir for secretions. Therefore, ear infections are rare in older children and adults.
I am certain that your physician would encourage you to seek a second opinion and want you to have all of your questions and concerns addressed before you make a decision about which course of action is best for your child.
Lillian Beard, M.D.
Pediatrics
Lillian M. Beard, M.D, a Fellow of the American
Academy of Pediatrics, is an associate clinical
professor at the George Washington University School
of Medicine and Health Sciences in Washington, D.C.
She is a frequent guest expert and spokesperson on national
television programs, discussing issues related to children's health.
Dr. Beard practices pediatrics in Washington, D.C.
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