Should Your Child Get Ear Tubes?

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Does your child have constant ear infections? Ear tubes might be a good option. Find out pros, cons, and how to prep for surgery and recovery.

McKenna in the hospital after getting ear tubes

When McKenna, my third child, went in for her 18 month well-check, I was surprised when the doctor told me she had a double ear infection.

My older two children had never had ear infections, so I was no ear infection expert, but she displayed no common signs or symptoms of ear infection. Even so, the infection was pretty bad, so she went on antibiotics.

This began a long battle we fought for a year to get her ears to clear up before we finally started talking about ear tubes.

What Are Ear Tubes?

Ear tubes are small, hollow cylinders that are surgically inserted in the eardrum. They are made of plastic or metal.

This allows the middle ear to drain and thus prevents painful ear infections.

Why and When Are Ear Tubes Needed?

If your child is one who gets ear infection after ear infection, you might find yourself talking about ear tubes (if not, you should be at least talking about it and considering it with the doctor, so bring it up).

Constant ear infections are a problem for multiple reasons. If your child has ear infections at all times, it can lead to speech delays since your child will not be able to hear well while she has an infection.

Ear infections can also cause hearing loss.

Tubes are used to prevent fluid buildup in the middle ear. They allow drainage and airflow in the child’s ear.

You will find the discussion of whether or not to get ear tubes will come up if:

  • Your child has had 3 or more ear infections in 6 months
  • Your child has had more than 4 ear infections in a year
  • Is showing signs of hearing loss and/or speech delays because of the build-up of fluid
  • Has a collapsed ear drum

I would like to say this isn’t a decision to take lightly or rush. For us, however, it was a pretty rushed decision. McKenna had infection on top of infection year-round starting at 18 months.

By age 2.5, her pediatrician said if things didn’t get better soon, we needed to consult with an ENT (Ear Nose and Throat specialist) about tubes.

We were at the point that I didn’t even need to call or make an appointment for McKenna to be seen, we could walk in and they would get us in there to check her ears. We got checked consistently to watch the infection and monitor it.

Well, things didn’t clear up. My doctor called the ENT and we were in the office the next day.

My husband and I were about to head on out to Hawaii for 10 days, so if we were going to do it, we had to get it done soon. And turns out that meant the next day.

I didn’t have the time you know I wanted to prepare for this surgery! No mental prep for McKenna (or myself!). No pre-shopping so we wouldn’t need anything during recovery. No researching this into the ground.

It was here. I want to share some information about ear tubes here to help you decide if you want them or not, know what you might expect if you do, know what to do while you have the tubes, and what to do afterward. 

Pros and Cons of Ear Tubes

Ear tubes are great. They help drain the ear and keep the infection from building up.

This helps so the child can hear more clearly. This is very crucial during these young years during speech development. 

Getting ear tubes:

  • Helps ensure the child can hear clearly and can thus develop speech in a normal pattern.
  • Helps prevent hearing loss that can be caused by having too much fluid on the ear too long.
  • Helps children be calmer, happier, and more obedient. This happens because the child is no longer in constant pain and can hear again.
  • Helps children sleep better since the pain of infection and fever will be gone.
  • Helps prevent infections (reduces the occurrence of infections).
  • Helps with balance problems.

Sounds pretty awesome right? You might wonder why someone might not choose to get tubes in? Here are some possible complications with ear tube surgery:

  • Anesthesia is always a risk. This is a quick, simple surgery, but there is always risk associated with general anesthesia. 
  • Perforation. If the hole made by the tube does not heal, a permanent hole can be left behind. This has to be fixed by another surgery. This one is not so simple, and the healing process is quite a pain. The child is supposed to not move for weeks and not get water in the ears for even more weeks. Not an easy thing (my neighbor had this happen to her daughter). If this is not fixed, permanent hearing loss can occur.
  • When an ear infection does happen, it is gross. The infection just flows out of the ear. Yeah. Gross. But in my opinion, this is just an annoyance and really shouldn’t weigh heavily on the decision. Just be aware of it. 
  • The tubes let water rush in and this can be highly unsettling, upsetting, and annoying to the child. McKenna hated being in anything other than warm water while she had tubes in.
  • Timing the removal right is a gamble. If you take it out too soon, you might end up having to repeat the process. Take it out to late, and you are more likely to end up with a hole in the ear drum that won’t heal. To me, this is the biggest negative against the ear tubes. 

Steps to Take Before Choosing Surgery

There are some things I would do before resorting to surgery and ear tubes (sometimes called tympanostomy tubes).

What is the Cause of Infections?

Consider what is causing the infections.

Some ear infections can actually be caused by food allergies. If this is your child’s case, staying away from the food can be your problem solved rather than ear tubes.

In McKenna’s case, the ENT found her tonsils were humongous when he was operating on her ears. This meant her surgery went from simple one-day recovery to a two-week recovery as she got her tonsils out.

Yeah. Not fun. I was definitely not prepared.

But there was so much infection in those tonsils that her ears were in a perpetual state of infection, also. The surgeon said that is probably what was causing the infections.

The thing here, however, is that you could try just removing the tonsils, but if that didn’t work, you would be going back in for surgery for tubes later. So you almost might as well do both at once.

Would Something Else Work?

Before moving to surgery, would something else work? Have you exhausted all options?

Steroids is an option for treating ear infections. This isn’t a step I wanted to take. I didn’t want the side effects of steroids going on. 

Some people swear by going to a chiropractor to solve ear infections. Sometimes a misalignment can be the cause of the infections.

Garlic oil and essential oils. You might find you can stave off the infections by using some homeopathic remedies like garlic oil. 

There are also oral antibiotics, but my guess is you have tried this extensively if you are considering tubes at this point.

Deciding to Get the Surgery

My opinion here is if you can’t get the infection to go away, you need to go with the tubes. Being able to hear is crucial for these children in learning to talk.

If I had it to do again, I would try the oils first. I might even try a chiropractor. But if those didn’t work, I would do the tubes again.

Risks of Ear Tube Placement

While this is a safe procedure, any surgery will have risks associated with it. Some risks include:

  • Common risks with anesthesia (nausea, vomitting, allergic reaction, breathing difficulties, irregular heartbeat)
  • Bleeding or infection
  • Fluid drainage that doesn’t stop
  • Tubes getting blocked
  • Scarring the eardrum
  • Weakening the ear drum
  • Tubes falling out
  • Tubes staying in too long
  • A hole staying in the eardrum and not closing on its own.

What is the Surgery and Recovery Like?

Every hospital has its different policies and procedures.

Leading up to surgery, your child will need to fast for a period of time. Your hospital will let you know.

The surgery itself is quite simple. It is outpatient. Your child will have anesthesia. There is a small incision made in the ear drum, the fluid is suctioned out, the tube is put in the incision hole, and your child is done.

It is usually about 15 minutes long. If your child gets adenoid out at the same time, it can take a bit longer. 

Your child will then be brought back to you and monitored in a recovery room for 1-2 hours. This experience will depend on what type of anesthesia child your child is. Some are groggy. Some are emotional. Some young children are right out angry (Brayden is an angry one). 

Bring a special blanket or stuffed animal to hospital with you.

Once you are home, you will spend the day just relaxing.

You will likely have ear drops for a few days. I can’t tell you how much of an impact it had since we did tonsils that the same time. I can say the ears were a non-issue for her. But we did spend the day watching TV. Her throat was sore.

I would plan on taking the day to just relax.

How to Prepare for Ear Tube Surgery

I would recommend you talk to your child about the surgery. You likely will not be able to attend your child into the operating room. I was able to go to a certain point in the hospital and then the child had to leave me.

You want your child mentally prepared. Talk about what will happen without giving details your child doesn’t need. Phrase things in a child-friendly way.

You know your child best and know how much is good information and what is not.

Talk about the good things that will come of the surgery.

>>>Read: How to Prepare Your Child for Surgery

Make sure you know:

  • What time your child needs to fast
  • What time to arrive at the hospital
  • Where to check in
  • What you can bring and can’t bring
  • How long the proceedure should take
  • How long your child will be down and out
  • Instructions on recovery

Do any needed shopping for snacks or foods before the surgery so you don’t have to take out a recovering patient.

LIFE WITH TUBES

You won’t notice much with the tubes in a negative way.

You will notice your child can hear immediately. You will notice your child is more pleasant, behavior is improved, and likely sleeps better.

Your child can unfortunately still get ear infections even with tubes. Your child probably won’t get a lot of infections, but will likely get some.

If your child gets an ear infection, you will notice the infection oozing out of the ear. There will be ear drainage and discharge. A nice thing is antibiotic ear drops should take care of that quickly.

One thing we noticed was that McKenna didn’t like cold water. She didn’t mind her ears being in warm water, but she hated cold water.

This made swimming lessons hard because she would be upset when her head went underwater. A lot of kids get earplugs for water while they have tubes in.

So you can still go swimming with ear tubes, but you might need earplugs to make it pleasant. Some ENTs might want them even if your child doesn’t mind the water.

You will want to make sure you go to your appointments with the doctor.

We had a post-op appointment. We then had a 6 months post-op appointment. Then we went a year later. At that time, he told me to go in about 9-10 months to have them removed.

At appointments, the doctor checks the tubes to make sure they are looking good and everything is fine.

When Will Ear Tubes Be Removed?

Getting tubes removed was different than I envisioned from how it was described to me.

Some tubes are designed to fall out naturally on their own. The kind McKenna had was one that needs to be removed.

I was told it was done in the office and is easy. So I thought would be literally in the exam room using some tweezers. That is what I had McKenna prepared for. 

The ENT actually has a room for minor procedures at his office. They gave McKenna some medicine to get her to be relaxed.

This was unnecessary–I had her very well prepared to sit still even if it hurt. I do wish I had been consulted about this before because I don’t think she needed it. On the flip side, however, if she didn’t hold still, there is a chance the hearing would be damaged, so I might have chosen the medicine just to be safe.

They then put her on the table and swaddled her in a giant sheet. Then a nurse leaned over her to hold her down (they must get some crazy things going on to go through so much effort to keep the child still).

Then the doctor uses tweezers to pull the tubes out (they put them in a treasure box for McKenna). Then the doctor put a paper patch over the hole to help it heal. It was an easy procedure. 

McKenna was unable to walk due to the medicine and we wheeled her to the car in a wheelchair. She then spent the rest of the day laying on the couch.

You are supposed to keep the ear dry for two weeks. This is also something I didn’t know before hand. If I had known, I would have scheduled it for a time of year other than early summer (hello swimming!). We survived.

You go in at two weeks after the procedure to check and make sure things have healed well. 

While McKenna was healing, she complained about her ear being sore and she was unable to pop her ears herself (you know when you switch altitudes in a plane? That happens a lot here just driving because of our mountain ranges).

Her ENT said it takes time to learn to pop the ears on their own since with tubes they don’t have to do it. 

Conclusion

If your child suffered from chronic ear infections, you might find yourself considering ear tubes. This post has all of the information you need to ask the right questions, decide, and prepare for the procedure.

Read About Our Ear Infection and Tubes Journey in These Posts

These posts will take you through our infections, the decision to get tubes, and getting them removed (as well as aftermath).

In the very last one, I mention that she had an infection and I hoped she wouldn’t get them constantly without tubes.

She has not, though it isn’t totally strange for her to get one each winter even as a preteen.

Related Posts

Read more here: Ear Tubes

This post originally appeared on this blog September 2014

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