Not every kid should get ear tubes to relieve excessive fluid buildup in the middle-ear canal, says a first-ever clinical guideline for physicians released today.
An extensive body of research shows that in cases where an otherwise healthy child gets middle-ear fluid, insertion of the tiny tubes (which help ventilate the middle ear and provide drainage) is not always necessary. Kids typically get better on their own, especially when the fluid is present for less than three months, says the recommendation from the American Academy of Otolaryngology — Head and Neck Surgery.
"The other circumstance where it's good to watch and wait, and this is a particularly novel aspect of this guideline, is if you have frequent or recurrent ear infections (known as acute otitis media, or AOM) without persistent fluid buildup," says Richard Rosenfeld, chair of the guideline panel and a pediatric ear, nose and throat specialist: "A lot of those kids are getting ear tubes, and it turns out it really doesn't help them."
Children who develop hearing difficulties and have fluid buildup (known as otitis media with effusion, or OME) in both ears for at least three months should be offered tube insertion because the fluid usually persists. Inserting tubes will improve hearing and quality of life, the recommendation says.
Nearly 670,000 ear tube surgeries (known as a myringotomy) are performed annually on children under age 15, making it the most common outpatient surgery for kids, according to the National Center for Health Statistics. By age 3, nearly one in 15 kids have received the tubes, officially known as tympanostomy tubes.
The tiny, hollow, plastic devices are inserted via a small incision in the eardrum, usually in an outpatient surgical procedure under general anesthesia.
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