Question & Answer: Chronic Ear Infections & Ear Tube Placement
Concerned Parent:
My child has always had ear infections. Her first set of ear tubes just fell out and now, as we head into cold season, I worry that she might need a second set of tubes. What are the chances this might happen?
Dr. Sanders:
Congratulations! Now that your daughter has had one set of ear tubes, I hope she finds relief this season and remains ear infection free. While the chances are relatively low, there is a possibility she may need a second set. To understand why, let’s take a quick look at the anatomy of the ear.
Ear infections occur in the middle ear. Our middle ear ventilates or drains through the Eustachian tube which leads to the nose. Ear infections occur when the Eustachian tube becomes blocked by fluid, preventing our middle ear from ventilating. Blockages happen more frequently in children who, in general, have a smaller anatomy including smaller Eustachian tubes.
As we all know, ear infections can be very painful for our little ones and impact their ability to hear. Some children experience reoccurring ear infections and benefit from the placement of ear tubes. When we place ear tubes, we create a small hole in the eardrum. This hole is then kept open with a small ear tube that allows the middle ear to ventilate through the eardrum instead of depending on the Eustachian tube, which is prone to blockages.
Most ear tubes fall out after six to twelve months. As a child grows, the Eustachian tube also grows and, most often, functions properly once the ear tube falls out. In about 25% of children who require ear tubes for chronic middle ear infections, the Eustachian tube is still not able to work properly after the first set of ear tubes fall out. These children might benefit from a second set of tubes. Sometimes, an adenoidectomy is also performed at the same time as the ear tubes are placed. This simple procedure reduces the swelling in the back of the nose that contributes to the blocked Eustachian tube. A third set of ear tubes is rarely required unless there is an underlying structural issue preventing the Eustachian tube from functioning properly.
If your daughter’s ear infections return, don’t panic! Reach out to your provider to discuss options. And remember, she is not alone, and eventually, as she grows, her ears will be able to function on their own without the need for tubes.
Dr. Brian Sanders, MD, is a board-certified otolaryngologist (ENT) who is eager to share his knowledge with the RefuahHealth community. Dr. Sanders sees patients every Tuesday at our Main Site location.