Need For Ear Tubes Questioned

When kids get inner ear infections, doctors often put drainage tubes in their ears right away. The idea is to prevent hearing loss, which could lead to developmental problems.

But, reports The Early Show medical correspondent Dr. Emily Senay, a new study argues there's no need for that rush treatment.

Each year, hundreds of thousands of young children get those infections, Senay explains. In fact, otitis media, which is the medical term for inflammation in the middle ear (commonly referred to as an inner ear infection), is the most commonly diagnosed illness in children, after colds.

And youngsters who have recurring inner ear problems frequently have ear tubes inserted.

They are tiny plastic tubes shaped like a hollow spool, and are commonly used to relieve the symptoms of persistent middle ear effusion, which is essentially fluid in the inner ear, and to prevent future ear infections.

The tubes are inserted through a small hole in the eardrum while the child is under general anesthesia. The procedure has become one of the most commonly performed operations of any kind.

Once inserted, they relieve some of the symptoms of inner ear infections by enabling air to enter the middle ear and fluid to flow out.

If an ear infection is affecting a child's hearing, which often happens, ear tubes can restore hearing and prevent future buildup of fluid in the middle ear.

If a child complains of pain in the ears, the tubes can decrease that feeling of pressure in the ears, therefore decreasing pain.Doctors were long under the impression that getting ear tubes for a child at the first sign of infection would actually help head off developmental problems, or keep them from getting worse. But this study disputes that.

When a child has fluid in the middle ear, it reduces the ear's ability to conduct sound, because the eardrum and middle ear bones can't vibrate as they should, so sounds seem muffled. And the belief was that speech problems and developmental delays were a direct result of the temporary hearing loss from inner ear infections, so parents and doctors were inserting ear tubes in children at the first sign of trouble.

But in this new study out of the University of Pittsburgh, researchers closely followed more than 400 infants who had middle ear fluid for at least three months. The infants were either treated with tubes immediately or followed for up to nine months before tubes were inserted, if the problem persisted. The researchers then gave the two groups of children a series of tests at the age of three to see if the timing of when the ear tube was inserted had any effect on their developmental skills.

After looking at the test results, they found that there were no significant differences between the early-treatment group and the late-treatment group.

So the bottom-line? Getting ear tubes inserted at the first sign of an inner ear infection doesn't improve developmental outcomes of children.

As common as the procedure is, the researchers say doctors can now take a more conservative approach when treating children with the infections, knowing that the insertion of the tubes is unlikely to affect their developmental skills. There's always a risk when putting young children under general anesthesia for surgery.

The team will continue to follow these children. Senay says she thinks they'll conduct another round of tests when they reach age six, and again when they're eight or nine, to see if the timing of the insertion of the tubes seems to affect their skills later in life.

Doctors suggest that if a child has at least three inner ear infections in six months or four infections in a year, he or she may be a good candidate for the tubes. Otherwise, antibiotics such as amoxicillin have proven effective in treating inner ear infections.