DecisionAssist - Ear tube insertion

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Ear tube insertion

Introduction

The purpose of this tool is to help you decide whether ear tube insertion is right for your child. When making a decision like this, you must balance:

The reasons for doing the procedure
The potential health risks, drawbacks, or limitations of the procedure
Whether there are alternative procedures that may be more appropriate
Cost

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. Surgery always carries risks, and you should be fully informed about the risks and benefits of this type of surgery. You should also be aware that research evidence is often limited, and the risks of surgery may not be completely understood. For this type of surgery, there is usually no exact "right" or "wrong" answer.

Your physician may make certain recommendations to you. However, the final decision about whether to have the surgery rests with you.

What is the procedure?

Ear tube insertion is a procedure to drain fluid that has built up behind a child's eardrums. The purpose of the procedure is to restore the normal functioning of the ear. While the child is under general anesthesia, a small incision is made in the eardrum. The fluid is suctioned out. A small tube will be inserted through the eardrum incision. The tube allows air to flow in, and fluid to continuously flow out, of the middle ear.

Click on the icon to see an illustrated series detailing ear tube insertion

The incision heals on its own, without the need for sutures. The hole closes and the ear tubes usually fall out naturally, after an average of 14 months or so.

Key points

Weigh the potential benefits versus the potential risks. For the right child, the benefits of ear tube insertion far outweigh the chance of harm.
Ear tube insertion may improve hearing, reduce fluid in the ear, reduce the frequency of ear infections, prevent language or other developmental problems, prevent damage to ear structures, and allow for healing of already damaged structures.
The risks of ear tube insertion include the risks of anesthesia, as well as minor scarring and bleeding that may accompany the tube insertion itself.

How much time this decision tool will take

5 - 10 minutes

What this tool will provide

A personalized list of factors for you to weigh
Questions to ask your doctor
Alternatives to this procedure
Recommended reading

Review Date: 10/7/2009
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Previously reviewed by Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network (7/26/2007).

References:

Ely JW, Hansen MR, Clark EC.Diagnosis of ear pain. Am Fam Physician. 2008 Mar 1;77(5):621-8. Review.
Academy of Family Physicians, American Academy of Pediatrics. Clinical Practice Guideline: Otitis Media With Effusion. Pediatrics. 2004;113(5):1412-1429
Hoover H, Roddey OF. The overlooked importance of tympanic membrane bulging. Pediatrics. 2005;115(2):513-513.
Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, Rockette HE, Pitcairn DL, et al. Tympanostomy tubes and developmental outcomes at 9 to 11 years of age. N Engl J Med. 2007; 356(3):248-61.
Paradise JL, Bluestone CD. Consultation with the specialist: Tympanostomy tubes: A contemporary guide to judicious use. Pediatrics in Review. 2005;26(2):61-66.

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