Tubes for 2 year-old son's ears

[Raine9]

Hi doctor,

My son, who will be 2 in May, has had approximately 8 ear infections in his life.  Recently, his pediatrician referred me to an ENT to have his hearing evaluated.  The hearing evaluation took place yesterday and it was discovered that his hearing is not within normal limits.  I was shown a chart and the ENT told me that his hearing should fall within the range which was labeled 0-20.  My son's hearing fell in the low 30s.  They also performed another test to see if there was pressure or fluid in his ears.  This test also suggested there might be fluid.  Therefore, the ENT recommended that my son have tubes placed in his ears.  His recommendation was based on the following factors:

1.  High number of ear infections.
2.  Abnormal hearing tests.
3.  Delayed speech (My son does not really say any words clearly)

I understand that this procedure, for the most part, is rather simple and very common.  Still, I feel that it is my duty as his mother, to research as much as possible and determine if it is ABSOLUTELY necessary as general anesthesia will be administered.  

Do you agree with the ENT?  If so, can you tell me all the pros and cons, risks, benefits, etc.?  

Lastly, [and since I'm paying for this question, I gotta get my money's worth! (lol)]  the ENT said that children undergoing this procedure show an almost immediate improvement in their speech.  Do you agree with this?


Thank you so much!

[Eric P Wilkinson, MD]

If you don't have surgery, your son will continue with the hearing loss due to fluid behind the eardrum. All of the reasons your ENT suggested tubes are proper reasons.  However, speech may not IMMEDIATELY improve, but you should see changes.  Sometimes children need speech therapy also if they have had speech delay due to hearing loss.

Pros--hearing improvement, hopefully better speech with time, less ear infections behind the eardrum
Cons--have to keep water out of the ears, possible otorrhea needing ear drop treatment if water gets in the ears or ears otherwise get infected, risk of permanent perforation (low, probably in the single digits).

Hope this helps.  Good luck!

This answer is not intended as and does not substitute for medical
advice - the information presented is for patients education only.
Please see your personal physician for further evaluation of your
individual case.

[Raine9]

I forgot one more thing.  What will happen if I DON'T go through with the surgery???

[SueSpa]

My son had a cold/croup a couple of weeks ago.  His f/up visit showed some fluid still in his ears so the Dr. told us to try antibiotic eardrops.  He's quite active so that was nearly impossible.  Did this for 2 days, but she gave us prescrip. for Augmentin if he started fever, which he did.  So on that Saturday we started giving him Augmentin.  It's now Tuesday and he woke up with 100.8, but slept all night.  Should I wait a day, or take him today to be re-evaluated based on the fact he is still running fevers from Saturday (today is Tues.) and he's definitely not feeling better yet, cranky?