Ear tubes for toddlers are typically small, hollow cylinders which are made from metal or plastic. Surgeons placed them into the eardrum of the child to create an airway that ventilates the middle ear. This outcome prevents the accumulation of fluids behind the eardrum that can lead to various infections. Too much fluid can also lead to hearing loss, affect speech development, and place painful pressure in the sinuses.
Ear tubes are sometimes called pressure-equalization, myringotomy, ventilation, or tympanostomy tubes. Most children have them fall out about 6-9 months after their placement. The holes they create often shut on their own as well. Some children do need to have the tubes removed and the holes surgically closed afterward.
The goal is to encourage long-term drainage when normal ear ventilation is not presence for some reason. As with any medical procedure, there are some pros and cons of ear tubes which are important to evaluate before deciding to go through with this option.
List of the Pros of Ear Tubes in Toddlers
1. Ear tubes create enough ventilation to reduce the risk of a future ear infection.
Bacteria has a challenging time with growth once your child’s doctor places the ear tubes into their proper position. The fluid which gets trapped in the ear is the perfect place for this breeding process to occur, so having it trickle out can help to reduce the number of infections that happen before the age of 5. Since your little one will start feeling better right away, that means you won’t need to start dealing with all of their crankiness from the moment they wake up in the morning.
2. It can help to restore hearing for children who experience problems in this area.
The fluid that gets trapped behind the eardrum can modify or dampen the soundwaves that the ear picks up. By placing the tubes correctly to drain this fluid, then an immediate restoration of hearing occurs. Kids who experienced this issue can often see a majority of their hearing come back within 48 hours.
As long as the fluid buildup does not occur again for some reason, this advantage of ear tubes is permanent. If the tubes come out and the fluid does start collecting, your doctor might recommend a second set to continue experiencing the benefits.
3. This procedure does not harm the speech development process.
Because the placement of ear tubes in toddlers helps to remove the fluid that can build up behind their eardrum, this procedure can help them continue with their speech development. Sounds will appear for processing as they would normally, allowing for a better understanding of language during the first formative years of brain development.
4. The tubes give children time to mature so that their eustachian tube can develop.
Children who receive a recommendation for ear tubes usually have problems with the development of their eustachian tube. That’s why fluids build up in the first place behind the eardrum. This problem can occur in teens and adults as well, especially if there is a malformation of the ear structure present.
If you have ever experienced a barotrauma, then your doctor might recommend ear tubes. It is also suggested for people with Down syndrome, a cleft palette, or other health issues that directly impact the eardrum in some way.
5. It can improve communication, sleep, and behavioral patterns.
Ear tubes for toddlers will help to remove the pressure that can develop behind the eardrum, which allows them to see a reduction in pain and discomfort as it disappears. Do you know how it feels when you’re on an airplane or going up an elevator quickly and it feels like your ears need to “pop”? That’s the same feeling a toddler with trapped fluid experiences every day. This procedure will get rid of it for them for good.
6. Treating future ear infections becomes a lot easier.
Once the ear tubes are in place, then you can place antibiotic drops directly into the ear canal to treat the issue. That method is more effective than an oral product to remove the infection, and it reduces the risk of antibiotic resistance development. Because you can treat the area of concern directly with the opening, you can have the little one starting to feel better in a very short time as well.
List of the Cons of Ear Tubes in Toddlers
1. Some children with ear tubes will still get infections.
Some kids have eardrums which are particularly sensitive to the pressure that can occur because of the presence of fluid. In this situation, there is still a significant risk of an infection since there would still be “pools” where bacteria could thrive. Although you can treat this problem with an eardrop antibiotic, the presence of the tube can make it become more painful than what it would be with a “standard” infection.
Most toddlers can see an improvement in their future symptoms with the placement of ear tubes, but there are some who will still get infections. Unless there is a noticeable malformation of the eardrum, there is no way to really know what the outcome will be until after the surgery.
2. There may be trouble with the tubes coming out.
When ear tubes are placed in toddlers, the physician will create a small space in the eardrum to insert the product. This placement allows any fluid that has built up behind the ear to begin draining out, providing a myriad of health benefits with that result. There are times when a tube might not be placed correctly or one of the tubes might decide to come out on its own too soon. You might also have one of the tubes get stuck and refuse to come out.
The only way to remove a stuck ear tube is through another surgery, which means you’re taking on all of the risks once again with this procedure.
3. A few kids need to have their ear tubes replaced because of ongoing issues.
The goal of having ear tubes placed is to prevent their need in the future. Most kids will have them fall out in about a year, while some might need to have them surgically removed for a variety of reasons. A handful of toddlers need to have another set of tubes placed for drainage because their development does not follow the typical course, which means parents are stuck with another surgery bill for this procedure.
Some tubes get blocked with mucus, blood, or other body secretions and require ongoing maintenance as well. Persistent drainage of fluid can indicate another health issue is present. That’s why you’ll typically have several follow-up appointments afterward to ensure everything is proceeding smoothly.
4. This procedure may leave a small scar in the eardrum.
Because there is a hole in the ear that needs to heal, there can be some scar tissue that develops at or near the eardrum which can impact the hearing of the child like there is fluid returning. Even the irritation of the eardrum can cause this problem, which is called either myringosclerosis or tympanosclerosis. A tiny incision in the eardrum is necessary as well, which can create this issue. Most children will not encounter this disadvantage, but it does interfere with hearing for some.
5. Infections are possible because of the insertion of the ear tube.
When you decide to have ear tubes for your toddler, then you are making the decision to have a surgical procedure performed on your child. Although the work is straightforward, you must still assume the risks of a surgery. That means there is anesthesia and an IV for your child, along with the problem of an infection occurring because of the procedure. It is a minor treatment with severe risks considered to be exceptionally rare, but they do exist.
About 500,000 ear tube surgeries are performed in the United States each year, making it the most common procedure performed on kids using general anesthesia. Most receive them between the ages of 1-3, but anyone at any age may be a good candidate for this option.
6. Ear tubes may be overprescribed by some doctors.
Dr. Nina Shapiro describes the pain from an ear infection as being sharp and stabbing, which is a horrible outcome for children to experience. She also believes that tubes are being over-prescribed in some instances. “Some children have what a parent considers a lot of infections,” she told NPR. “Maybe they’ve had three infections this year… But remember, children get 10-12 cold a year, which is really about one per month. So, if they’re getting a few ear infections, that’s considered normal.”
7. The cost of surgery is prohibitive to families without insurance.
Dr. Steve Berman serves as a professor of pediatrics at the University of Colorado and is the Director of Pediatrics at Children’s Hospital in Denver. Berman has also served in the past as President of the American Academy of Pediatrics. He describes the procedure as being expensive. “Each of those surgeries probably costs between $3,5000 and $5,000,” he told NPR. “So, we’re potentially talking about a lot of money that could be saved by avoiding these unnecessary surgeries. He believes that up to one-third of the ear tube procedures performed each year might be unnecessary.
8. You will see a lot of apprehension from your child.
The day of the surgery for the ear tubes is rough for toddlers – or kids of all ages, for that matter. Younger kids typically have the procedure scheduled for the early morning, while grade schoolers tend to see late morning or early afternoon times. Since you cannot eat or drink anything before the surgery, you’ll have an unhappy kiddo on your hands. The benefits of hearing better and having fewer ear infections are often worthwhile, but you will need to prepare yourself for this potential issue.
9. It can change some of the activities that you love.
If you want to go swimming with ear tubes in place, then you must wear plugs that will prevent water from getting into the ear. You’ll need to wear them while taking a bath or shower too, especially for the first couple of weeks after the surgery to prevent moisture from getting behind your eardrum. Even though kids would need to go to a depth of six feet to create problems, there can be sensitivities for kids up to 3 months after the surgery that can be bothersome with liquid exposure.
The pros and cons of ear tubes in toddlers offer an option for relief so that hearing and speech development receives a minimal impact for the child. Although there are some risks to consider with this procedure, the benefits of hearing restoration, improved speech and balanced, better sleep, and a reduction of future ear infection risks often outweigh the potential disadvantages. Only your doctor can decide if this option will meet your needs, so you’ll want to schedule an appointment right away to discuss any concerns you may have.