Table of ContentsView AllTable of ContentsProne to InfectionsIndicationsBenefitsRisksPrevention of Ear Infections
Table of ContentsView All
View All
Table of Contents
Prone to Infections
Indications
Benefits
Risks
Prevention of Ear Infections
Fortunately, most kids only get a few ear infections (called otitis media), if any, per year. But if your child gets recurrent infections, your pediatrician may recommend inserting ear tubes. Here’s what to know about how many infections warrant tubes, what your healthcare provider will take into consideration when suggesting them, and how to weigh the benefits and risks of this surgery.Cultura Science / Sigrid Gombert / Riser / Getty ImagesWhy Babies and Children Are Prone to Ear InfectionsBabies and children are at higher risk of getting ear infections than adults because:They have shorter, more horizontal, and narrower eustachian tubes, making them less likely to drain effectively, causing a back-up of fluid in the ear.Their immune systems are still developing, making them susceptible to viral and bacterial infections, especially if they are around other children frequently or in daycare.Their adenoids are larger than adults'. Adenoids are located in the back of the nose near the opening of the eustachian tubes and can block the tubes if they become swollen or inflamed.Having respiratory allergies and a family history of ear infections increases the risk.What Causes Ear Infections?IndicationsEar tube placement surgery is the most common elective surgery in children in the United States.Ear tubes are tiny cylinders placed through the eardrum (tympanic membrane) to allow air into the middle ear. They are called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. The tubes can be made of plastic, metal, or Teflon, and may have a coating intended to reduce possible infection.There are no cut-and-dry rules for when tube placement surgery is indicated. Many experts consider tubes for a child who has had three ear infections in six months or four ear infections in 12 months.Others decide to place tubes when infections are frequent and close together, particularly painful ear infections, or when an ear infection does not clear after a period of time with appropriate antibiotics.Tubes are also recommended when a child hasfluid in their ears (otitis with effusion)for more than three months and/or temporaryhearing loss.BenefitsBy far the most important benefit of ear tubes is that they improve the quality of life for many children, especially in cases where hearing is affected. Hearing problems can have a negative effect on learning and behavior.RisksEar tube surgery usually lasts half an hour or less. Your child will be sedated and should not have much, if any, pain. Complications may occur with any surgical procedure. Possible complications of ear tube surgery include:Loss of the tubes: Sometimes the tubes fall out early when they are still needed.Blockage of the tubes: This occurs in around 10 percent of children.Drainage from the tubes (otorrhea): While annoying, drainage from ear tubes can be treated with topical drops and does not usually require oral antibiotics.Granulomas- Scar tissue formation in the eardrumCholesteatomas: A skin growth behind the eardrumTympanic membrane perforationRisks of general anesthesiaAlthough some children have complications after getting ear tubes, they are rarely serious. Numerousstudieshave shown improved quality of life outcomes for children after getting tubes.Prevention of Ear InfectionsIf you can reduce the number of ear infections for your child, you may lower the chances that she will need ear tubes. Certainly, this is not always possible, and even the most attentive and caring parents frequently have children who end up needing ear tubes. Some measures that may possibly make a difference include:BreastfeedingReducing or eliminating exposure to secondhand smokeReducing pacifier useKeeping your child from drinking from a bottle while lying downReducing exposure to others who are illA Word From VerywellIf you think your child has had too many ear infections, ask your pediatrician for a referral to a pediatric ENT specialist to discuss if ear tubes would be appropriate. A pediatric ENT doctor can also provide a second opinion if you think your pediatrician is recommending tubes unnecessarily.
Fortunately, most kids only get a few ear infections (called otitis media), if any, per year. But if your child gets recurrent infections, your pediatrician may recommend inserting ear tubes. Here’s what to know about how many infections warrant tubes, what your healthcare provider will take into consideration when suggesting them, and how to weigh the benefits and risks of this surgery.
Cultura Science / Sigrid Gombert / Riser / Getty Images
Why Babies and Children Are Prone to Ear Infections
Babies and children are at higher risk of getting ear infections than adults because:
Having respiratory allergies and a family history of ear infections increases the risk.
What Causes Ear Infections?
Ear tube placement surgery is the most common elective surgery in children in the United States.Ear tubes are tiny cylinders placed through the eardrum (tympanic membrane) to allow air into the middle ear. They are called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. The tubes can be made of plastic, metal, or Teflon, and may have a coating intended to reduce possible infection.
There are no cut-and-dry rules for when tube placement surgery is indicated. Many experts consider tubes for a child who has had three ear infections in six months or four ear infections in 12 months.Others decide to place tubes when infections are frequent and close together, particularly painful ear infections, or when an ear infection does not clear after a period of time with appropriate antibiotics.
Tubes are also recommended when a child hasfluid in their ears (otitis with effusion)for more than three months and/or temporaryhearing loss.
By far the most important benefit of ear tubes is that they improve the quality of life for many children, especially in cases where hearing is affected. Hearing problems can have a negative effect on learning and behavior.
Ear tube surgery usually lasts half an hour or less. Your child will be sedated and should not have much, if any, pain. Complications may occur with any surgical procedure. Possible complications of ear tube surgery include:
Although some children have complications after getting ear tubes, they are rarely serious. Numerousstudieshave shown improved quality of life outcomes for children after getting tubes.
If you can reduce the number of ear infections for your child, you may lower the chances that she will need ear tubes. Certainly, this is not always possible, and even the most attentive and caring parents frequently have children who end up needing ear tubes. Some measures that may possibly make a difference include:
A Word From Verywell
If you think your child has had too many ear infections, ask your pediatrician for a referral to a pediatric ENT specialist to discuss if ear tubes would be appropriate. A pediatric ENT doctor can also provide a second opinion if you think your pediatrician is recommending tubes unnecessarily.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ear infections.Paediatr Child Health. 2009;14(7):465-468. doi:10.1093/pch/14.7.465Marom T, Nokso-Koivisto J, Chonmaitree T.Viral-bacterial interactions in acute otitis media.Curr Allergy Asthma Rep. 2012;12(6):551–558. doi:10.1007/s11882-012-0303-2Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep. 2017;5(2):93-100. doi:10.1007/s40136-017-0151-7Karunanayake CP, Albritton W, Rennie DC, et al.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr. 2016;2016:1523897. doi:10.1155/2016/1523897Robinson H, Engelhardt T.Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives.Local Reg Anesth. 2017;10:41-49. doi:10.2147/LRA.S113591Rosenfeld RM, Schwartz SR, Pynnonen MA, et al.Clinical practice guideline: Tympanostomy tubes in children.Otolaryngol Head Neck Surg. 2013;149(1 Suppl):S1-35. doi:10.1177/0194599813487302Steele DW, Adam GP, Di M, Halladay CH, Balk EM, Trikalinos TA.Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis. Pediatrics. 2017;139(6)Ah-Tye C, Paradise JL, Colborn DK.Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration.Pediatrics. 2001;107(6):1251-1258. doi:10.1542/peds.107.6.1251Kuruma T, Tanigawa T, Uchida Y, Tetsuya O, Ueda H.Large Cholesterol Granuloma of the Middle Ear Eroding into the Middle Cranial Fossa.Case Rep Otolaryngol. 2017;2017:4793786. doi:10.1155/2017/4793786Gao T, Li X, Hu J, et al.Management of traumatic tympanic membrane perforation: a comparative study.Ther Clin Risk Manag. 2017;13:927-931. doi:10.2147/TCRM.S139631Csákányi Z, Czinner A, Spangler J, Rogers T, Katona G.Relationship of environmental tobacco smoke to otitis media (OM) in children.Int J Pediatr Otorhinolaryngol. 2012;76(7):989-993. doi:10.1016/j.ijporl.2012.03.017Additional ReadingConrad, D., Levi., Theroux, Z., Inverso, Y., and U. Shah. Risk factors associated with postoperative typanostomy tube obstruction.JAMA Otolarygology Head and Neck Surgery. 2014. 140(8):727-30. doi:10.1001/jamaoto.2014.1176.Grindler, D., Blank, S., Schulz, K., Witsell, D., and J. Lieu. Impact of Otitis Media Severity on Children’s Quality of Life.Otolaryngology – Head and Neck Surgery. 2014. 151(2):333-340. doi: 10.1177/0194599814525576Rettig, E., and . Tunkel.Contemporary concepts in management of acute otitis media in children.Otolaryngology Clinics of North America. 2014. 47(5):651-72. doi:10.1016/j.otc.2014.06.006Rosenfelt, R., Shin, J., Schwartz, S. et al.Clinical Practice Guideline: Otitis Media with Effusion (Update).Otolaryngology – Head and Neck Surgery. 2016. 154(1 Suppl):S1-S41. doi: 10.1177/0194599815623467
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ear infections.Paediatr Child Health. 2009;14(7):465-468. doi:10.1093/pch/14.7.465Marom T, Nokso-Koivisto J, Chonmaitree T.Viral-bacterial interactions in acute otitis media.Curr Allergy Asthma Rep. 2012;12(6):551–558. doi:10.1007/s11882-012-0303-2Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep. 2017;5(2):93-100. doi:10.1007/s40136-017-0151-7Karunanayake CP, Albritton W, Rennie DC, et al.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr. 2016;2016:1523897. doi:10.1155/2016/1523897Robinson H, Engelhardt T.Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives.Local Reg Anesth. 2017;10:41-49. doi:10.2147/LRA.S113591Rosenfeld RM, Schwartz SR, Pynnonen MA, et al.Clinical practice guideline: Tympanostomy tubes in children.Otolaryngol Head Neck Surg. 2013;149(1 Suppl):S1-35. doi:10.1177/0194599813487302Steele DW, Adam GP, Di M, Halladay CH, Balk EM, Trikalinos TA.Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis. Pediatrics. 2017;139(6)Ah-Tye C, Paradise JL, Colborn DK.Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration.Pediatrics. 2001;107(6):1251-1258. doi:10.1542/peds.107.6.1251Kuruma T, Tanigawa T, Uchida Y, Tetsuya O, Ueda H.Large Cholesterol Granuloma of the Middle Ear Eroding into the Middle Cranial Fossa.Case Rep Otolaryngol. 2017;2017:4793786. doi:10.1155/2017/4793786Gao T, Li X, Hu J, et al.Management of traumatic tympanic membrane perforation: a comparative study.Ther Clin Risk Manag. 2017;13:927-931. doi:10.2147/TCRM.S139631Csákányi Z, Czinner A, Spangler J, Rogers T, Katona G.Relationship of environmental tobacco smoke to otitis media (OM) in children.Int J Pediatr Otorhinolaryngol. 2012;76(7):989-993. doi:10.1016/j.ijporl.2012.03.017Additional ReadingConrad, D., Levi., Theroux, Z., Inverso, Y., and U. Shah. Risk factors associated with postoperative typanostomy tube obstruction.JAMA Otolarygology Head and Neck Surgery. 2014. 140(8):727-30. doi:10.1001/jamaoto.2014.1176.Grindler, D., Blank, S., Schulz, K., Witsell, D., and J. Lieu. Impact of Otitis Media Severity on Children’s Quality of Life.Otolaryngology – Head and Neck Surgery. 2014. 151(2):333-340. doi: 10.1177/0194599814525576Rettig, E., and . Tunkel.Contemporary concepts in management of acute otitis media in children.Otolaryngology Clinics of North America. 2014. 47(5):651-72. doi:10.1016/j.otc.2014.06.006Rosenfelt, R., Shin, J., Schwartz, S. et al.Clinical Practice Guideline: Otitis Media with Effusion (Update).Otolaryngology – Head and Neck Surgery. 2016. 154(1 Suppl):S1-S41. doi: 10.1177/0194599815623467
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ear infections.Paediatr Child Health. 2009;14(7):465-468. doi:10.1093/pch/14.7.465Marom T, Nokso-Koivisto J, Chonmaitree T.Viral-bacterial interactions in acute otitis media.Curr Allergy Asthma Rep. 2012;12(6):551–558. doi:10.1007/s11882-012-0303-2Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep. 2017;5(2):93-100. doi:10.1007/s40136-017-0151-7Karunanayake CP, Albritton W, Rennie DC, et al.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr. 2016;2016:1523897. doi:10.1155/2016/1523897Robinson H, Engelhardt T.Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives.Local Reg Anesth. 2017;10:41-49. doi:10.2147/LRA.S113591Rosenfeld RM, Schwartz SR, Pynnonen MA, et al.Clinical practice guideline: Tympanostomy tubes in children.Otolaryngol Head Neck Surg. 2013;149(1 Suppl):S1-35. doi:10.1177/0194599813487302Steele DW, Adam GP, Di M, Halladay CH, Balk EM, Trikalinos TA.Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis. Pediatrics. 2017;139(6)Ah-Tye C, Paradise JL, Colborn DK.Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration.Pediatrics. 2001;107(6):1251-1258. doi:10.1542/peds.107.6.1251Kuruma T, Tanigawa T, Uchida Y, Tetsuya O, Ueda H.Large Cholesterol Granuloma of the Middle Ear Eroding into the Middle Cranial Fossa.Case Rep Otolaryngol. 2017;2017:4793786. doi:10.1155/2017/4793786Gao T, Li X, Hu J, et al.Management of traumatic tympanic membrane perforation: a comparative study.Ther Clin Risk Manag. 2017;13:927-931. doi:10.2147/TCRM.S139631Csákányi Z, Czinner A, Spangler J, Rogers T, Katona G.Relationship of environmental tobacco smoke to otitis media (OM) in children.Int J Pediatr Otorhinolaryngol. 2012;76(7):989-993. doi:10.1016/j.ijporl.2012.03.017
Ear infections.Paediatr Child Health. 2009;14(7):465-468. doi:10.1093/pch/14.7.465
Marom T, Nokso-Koivisto J, Chonmaitree T.Viral-bacterial interactions in acute otitis media.Curr Allergy Asthma Rep. 2012;12(6):551–558. doi:10.1007/s11882-012-0303-2
Granath A.Recurrent Acute Otitis Media: What Are the Options for Treatment and Prevention?Curr Otorhinolaryngol Rep. 2017;5(2):93-100. doi:10.1007/s40136-017-0151-7
Karunanayake CP, Albritton W, Rennie DC, et al.Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.Int J Pediatr. 2016;2016:1523897. doi:10.1155/2016/1523897
Robinson H, Engelhardt T.Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives.Local Reg Anesth. 2017;10:41-49. doi:10.2147/LRA.S113591
Rosenfeld RM, Schwartz SR, Pynnonen MA, et al.Clinical practice guideline: Tympanostomy tubes in children.Otolaryngol Head Neck Surg. 2013;149(1 Suppl):S1-35. doi:10.1177/0194599813487302
Steele DW, Adam GP, Di M, Halladay CH, Balk EM, Trikalinos TA.Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis. Pediatrics. 2017;139(6)
Ah-Tye C, Paradise JL, Colborn DK.Otorrhea in young children after tympanostomy-tube placement for persistent middle-ear effusion: prevalence, incidence, and duration.Pediatrics. 2001;107(6):1251-1258. doi:10.1542/peds.107.6.1251
Kuruma T, Tanigawa T, Uchida Y, Tetsuya O, Ueda H.Large Cholesterol Granuloma of the Middle Ear Eroding into the Middle Cranial Fossa.Case Rep Otolaryngol. 2017;2017:4793786. doi:10.1155/2017/4793786
Gao T, Li X, Hu J, et al.Management of traumatic tympanic membrane perforation: a comparative study.Ther Clin Risk Manag. 2017;13:927-931. doi:10.2147/TCRM.S139631
Csákányi Z, Czinner A, Spangler J, Rogers T, Katona G.Relationship of environmental tobacco smoke to otitis media (OM) in children.Int J Pediatr Otorhinolaryngol. 2012;76(7):989-993. doi:10.1016/j.ijporl.2012.03.017
Conrad, D., Levi., Theroux, Z., Inverso, Y., and U. Shah. Risk factors associated with postoperative typanostomy tube obstruction.JAMA Otolarygology Head and Neck Surgery. 2014. 140(8):727-30. doi:10.1001/jamaoto.2014.1176.Grindler, D., Blank, S., Schulz, K., Witsell, D., and J. Lieu. Impact of Otitis Media Severity on Children’s Quality of Life.Otolaryngology – Head and Neck Surgery. 2014. 151(2):333-340. doi: 10.1177/0194599814525576Rettig, E., and . Tunkel.Contemporary concepts in management of acute otitis media in children.Otolaryngology Clinics of North America. 2014. 47(5):651-72. doi:10.1016/j.otc.2014.06.006Rosenfelt, R., Shin, J., Schwartz, S. et al.Clinical Practice Guideline: Otitis Media with Effusion (Update).Otolaryngology – Head and Neck Surgery. 2016. 154(1 Suppl):S1-S41. doi: 10.1177/0194599815623467
Conrad, D., Levi., Theroux, Z., Inverso, Y., and U. Shah. Risk factors associated with postoperative typanostomy tube obstruction.JAMA Otolarygology Head and Neck Surgery. 2014. 140(8):727-30. doi:10.1001/jamaoto.2014.1176.
Grindler, D., Blank, S., Schulz, K., Witsell, D., and J. Lieu. Impact of Otitis Media Severity on Children’s Quality of Life.Otolaryngology – Head and Neck Surgery. 2014. 151(2):333-340. doi: 10.1177/0194599814525576
Rettig, E., and . Tunkel.Contemporary concepts in management of acute otitis media in children.Otolaryngology Clinics of North America. 2014. 47(5):651-72. doi:10.1016/j.otc.2014.06.006
Rosenfelt, R., Shin, J., Schwartz, S. et al.Clinical Practice Guideline: Otitis Media with Effusion (Update).Otolaryngology – Head and Neck Surgery. 2016. 154(1 Suppl):S1-S41. doi: 10.1177/0194599815623467
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
