Most parents have heard of ear tubes, but unless you or a child in your family has needed them, you might not really know much about them. What exactly are they and why do some children need them? We asked Allen Marshall, MD, otolaryngologist, WakeMed Ear, Nose & Throat – Head & Neck Surgery, to share a bit more about the ins and outs of the ear to help explain the need for ear tubes.

“Normally the middle ear is connected to the outside world by the eustachian tube,” says Dr. Marshall. “Ear tubes provide an alternate pathway when there is a disorder or dysfunction of the eustachian tube, which is commonly caused by infection.”

Because the eustachian tube helps equalize pressure in the ear, Dr. Marshall explains that a feeling of fullness similar to what you feel on an airplane can be an indication of infection or dysfunction.

“Problems with the eustachian tubes in young children are more common because they are not as fully developed,” explained Dr. Marshall.

Your child’s pediatrician will likely refer you to an Ear, Nose and Throat (ENT) specialist if your child has recurring ear infections, hearing concerns or other indications of eustachian tube dysfunction. The need for ear tubes can depend on a combination of circumstances, including the length of time between infections and the severity of inflammation or fluid buildup.

“By providing a temporary, alternate tube, we can help relieve discomfort or pain and, more importantly, help dry up and reduce inflammation in the eustachian tube,” says Dr. Marshall. “Antibiotic drops can also be put in the ear via temporary tubes.

“Approximately 80% of kids who get ear tubes only need them once.

“Parents might be worried about the process of getting the tubes, but they can rest assured knowing that it can be done as a day surgery with brief general anesthesia,” says Dr. Marshall. “After getting tubes, children are usually on antibiotic drops for about a week.”

It’s very common for children ages 1 to 3 to need ear tubes, but Dr. Marshall says they can be needed at both younger and older ages as well as in adulthood. He explained that some babies who fail a hearing screening will need them if it is found that they have fluid in their ears.

The need for ear tubes can run in families. Dr. Marshall commented that the majority of time at least one of the parents has had tubes, but that doesn’t necessarily mean that all kids in the family will need them.

Annoying Ear Infections

Ear infections are one of the most common reasons children need to see a doctor.

“By age 3, between 80 and 90% of kids have had an ear infection,” says Dr. Marshall. “Either a bacterial or viral infection of the middle ear can cause fluid to build up in the inner areas of the ear.”

Multiple ear infections do not necessarily mean a child will need ear tubes. Frequent infections in a short period of time or consistent fluid in the ear is more likely to be an indicator of the possible need for tubes.

Parents should never ignore any symptoms that indicate a problem with a child’s ears or hearing. Call their doctor if your child complains about ear pain, tugs at their ear, cries or gets fussier than usual. Other possible symptoms of ear infections or dysfunction include trouble sleeping or lying flat, trouble hearing or reacting to sounds, a loss of balance, fever, headaches, lack of appetite or ear drainage.

“Hearing loss is a real concern, especially when a blockage or infection goes unnoticed for too long,” says Dr. Marshall. “If a child says they can’t hear you, listen to them and call a doctor.”

Swimmer’s Ear Explained

Did you know you do not have to swim to develop swimmer’s ear? Although it is more common after water exposure, you can develop swimmer’s ear (otitis externa) without being in water.

“Excessive moisture irritates the ear canal skin, which allows for a bacterial or fungal infection,” explained Dr. Marshall. “Hot, humid summer environments contribute to this problem.”

To help prevent pesky water in the ears, consider earplugs for your child to use when swimming. A doctor’s treatment of swimmer’s ear might include the removal of excess wax, dead skin cells or debris to allow it to dry out.

“Don’t ever try to clean the inside of your child’s ears and check with your pediatrician before trying homemade drops,” says Dr. Marshall. “Topical treatment with antibiotic drops prescribed by your child’s doctor can help knock out bacteria, and steroids help reduce swelling.”

If your child has recurrent swimmer’s ear, seek the advice of an ENT specialist.

Hearing & Speech Connection

Brain development, literacy and language skills are all affected by hearing. Speech development concerns can indicate a problem with a child’s ability to hear. If there’s a speech concern, always get the child’s ears checked.

Where to Seek Care

Are you concerned about your child’s ears due to repeated ear infections, swimmer’s ear, ear pain or hearing or speech problems? WakeMed ENT – Head & Neck Surgeons provide top-quality pediatric ear, nose and throat care for infants, children and teens. Many of our patients are under the age of 16, and most of our board-certified physicians have had five to six years of specialty training (post-medical school) in caring for pediatric patients.

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Meet the Expert

Dr. Allen Marshall is an otolaryngologist with WakeMed Ear, Nose & Throat — Head & Neck Surgery. He earned his medical degree from The University of North Carolina at Chapel Hill School of Medicine, where he also completed a residency in Otolaryngology – Head & Neck Surgery. Dr. Marshall is an affiliated faculty member at UNC. He is board certified by the American Board of Otolaryngology. His clinical special interests include pediatric and adult ENT problems, including sinus disorders, thyroid surgery and ear disease.