For children with chronic ear infections, pressure equalization (PE) tubes may be just the ticket to better health and normal speech development. Ear infections can produce a fluctuating hearing loss, especially when fluid is present. While the effects are generally temporary, recurrent ear infections can cause a prolonged period in which your child is hearing things as if he is underwater. And that distorted speech perception can lead to expressive language delays as well as delays in articulation.
With repeated ear infections, a substantial amount of fluid can become trapped in the middle ear. In addition to a temporary hearing loss, this fluid buildup can become quite painful as pressure builds. As the fluid becomes a stagnant stew with nowhere to go, it starts to look like a 5-star hotel to bacteria looking for a place to hide out, hole up, and multiply.
Children have an increased risk of ear infections than due to their anatomy. There is a tube, called the Eustachian tube, which connects the middle ear to the back of the throat. The sensation of ears “popping” is actually your Eustachian tube opening and allowing the pressure in your middle ear equalize with the air pressure around you.
Children have horizontal Eustachian tubes. With maturity, the Eustachian tube begins to tilt downward so that any excess fluid in the middle ear naturally drains into the back of the throat. When the Eustachian tube opening in the back of the throat is blocked by enlarged adenoids the doctor may recommend a tonsillectomy and adenoidectomy to remove the blockage.
Inserting pressure equalization tubes is a relatively simple procedure in which the physician uses a surgical microscope and makes very small incision in the child’s eardrum and inserts very small tube in that hole. Once PE tubes are in place, the middle ear can drain into the outer ear canal. This may mean that you will see—and smell—thick, foul drainage as the middle ears dry up.
The risks associated with PE tube placement are minimal. In rare cases, hearing can worsen. In a very small percentage of cases, the eardrum can fail to close after the tubes come out, a condition that can be repaired easily. The benefits to tube placement nearly always include increased hearing acuity. In addition, equalization of pressure and reduction of middle ear fluid can dramatically relieve ear pain and reduce the risk of further infection. In many children, this is just the boost they need to reduce, and even eliminate, recurrent ear infections.
PE tubes are designed to stay in place and open for several months, in order to promote good ear health and the recurrence of ear infections. Sometimes they are removed by the doctor, but quite often they fall out into the outer ear canal on their own over time. If the tubes fall out too soon, or if a child continues to have ear infections after the tubes are removed, it may be necessary to put a new set in.
In general, PE tubes are hassle free, but you should check with your doctor first to find out any special precautions for bathing or swimming. In most cases, ear plugs will protect the middle ear when your child is going to be getting wet.
Children who have PE tubes installed usually enjoy a rapid spurt of language growth very soon after the tubes start doing their job.
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