Fact Sheets : Tubes For Ear Infections - The Facts

Repeated ear infections: consequences

Recurrence of ear infections is not uncommon. In the vast majority of children, there will be some fluid present behind the ear drum following an ear infection, and it usually clears on its own. But in some cases, fluid in the middle ear persists for more than 12 weeks, even after the infection has cleared up. The presence of fluid behind the eardrum may interfere with transmission of sound; in other words, it may cause a temporary reduction in hearing. If persistent fluid reduces a young child's hearing for an extended period of time, it may result in delayed language development and other problems. Also, if the fluid keeps getting infected this results in recurrent or repeated ear infections.

The signs of reduced hearing in children

With repeated infections, the child may show signs of reduced hearing. He may seem more inattentive, shout or speak loudly when talking, and sit closer to the television than he used to. Parents may find that they need to speak louder to the child in order to hold his attention. Another sign of reduced hearing in a very young child with recurring infections is that he or she is slower than other children in developing language skills.

Detecting fluid in the middle ear or a hearing problem

A physician can determine if there is persistent fluid by examining the eardrum with an otoscope; and/or with a special test called a "tympanogram" which can identify the presence of fluid in the middle ear. Hearing can be assessed with a test called an audiogram. If these tests confirm that there is persistent middle ear fluid causing reduced hearing, pressure equalization tubes (PE tubes)may be recommended for the child.

About PE tubes

PE tubes are inserted into the eardrum during a minor surgical procedure performed by an Ear-Nose and Throat (ENT) specialist. This simple process is by far the most common type of surgery performed on children in North America. Before surgery, young children are usually given a mild general anesthetic, but older children may only need a local anesthetic. Most children are allowed to return home the same day of the surgery. Once the microscopic tube is inserted into the eardrum, fluid in the middle ear is able to drain through to the outside. As the fluid drains, the eardrum is once again able to vibrate normally, so hearing is improved right away. The PE tube also helps prevent further infections. Since fluid drains to the outside, bacteria do not have a chance to multiply in the middle ear and cause infection.

Precautions with PE tubes

Because the PE tube opens a tiny hole between the outer and the middle ear, water can accidentally travel into the middle ear from the outside. To avoid this, children with tubes need to be careful not to get water into their ears. They should always wear ear plugs in the bath or pool, and avoid diving deeply into water. Depending on which type of tube used, your ENT doctor will give you specific instructions.

Removing PE tubes

The most commonly used type of PE tube stays in the eardrum for up to one year, then falls out naturally into the outer ear canal as the eardrum seals itself shut. The tube is then easily removed by a doctor, without surgery.