Ear tube for constant fluid in ear?

[staceyobu]

DS is three. He has only had one ear infection where he has run fever, not felt well, etc. However, since his two year old check up, they have been saying his ears don't "look good". The ped said it looks like there is fluid in one ear constantly.

 

The ped wants to do a month of allergy meds, a month of antibiotics, and if it's still not clear, a tube. I'm currently giving him the allergy meds but I'm just a little hesitant to do all this. DS has NO symptoms of ear infections whatsoever. No pain, no fever, no nothing. Good speech development.

 

*I* recently had a tube put in my ear and am now on my second ear infection since they put in the tube six weeks ago. :glare: So far, I'm not a fan. Some of my reading before I had my tube indicated that children with chronic fluid and no speech delay don't necessarily need a tube... they'll just outgrow the issue.

 

Anyone have any experience with this?

[Niffercoo]

DS is three. He has only had one ear infection where he has run fever, not felt well, etc. However, since his two year old check up, they have been saying his ears don't "look good". The ped said it looks like there is fluid in one ear constantly.

 

The ped wants to do a month of allergy meds, a month of antibiotics, and if it's still not clear, a tube. I'm currently giving him the allergy meds but I'm just a little hesitant to do all this. DS has NO symptoms of ear infections whatsoever. No pain, no fever, no nothing. Good speech development.

 

*I* recently had a tube put in my ear and am now on my second ear infection since they put in the tube six weeks ago. :glare: So far, I'm not a fan. Some of my reading before I had my tube indicated that children with chronic fluid and no speech delay don't necessarily need a tube... they'll just outgrow the issue.

 

Anyone have any experience with this?

 

 

I only have experience with it coming from the perspective of having a child with a severe speech delay. She had only ever had the one ear infection, and in fact, we only went for the hearing test because it was part of the Speech Therapist's protocol to rule out hearing loss. We ended up finding out she had 25% loss in both ears! They didn't even have us try the other things you mentioned first because her hearing loss was so bad and her speech was as well.

 

She was 3 when the tubes were placed, and she had them for 2.5 years - they had to be surgically removed because they never fell out on their own. During that time she only had one ear infection. The ENT told me that it was the structure of her ear canal that caused the fluid to not drain properly, and probably also didn't allow for the tubes to fall out on their own like they are supposed to. When we went back in for her follow-up exam, her ears were clear of fluid and her hearing tested fine. She was 'age appropriate' with her speech within a year, but she will likely always have a slight speech impediment because of the loss of the hearing during that crucial period.

 

One thing that I would try if it hasn't been suggested is to remove dairy from the child's diet and see if the fluid clears up. I'm not sure why it happens, but I've heard of that working. Other than that, if you are sure that the hearing isn't affected nor the speech (and I think I'd have both of those tested from an ST and an ENT), then I wouldn't rush into tubes. But I also wouldn't take ANY chance that the hearing/speech are compromised.

[staceyobu]

One thing that I would try if it hasn't been suggested is to remove dairy from the child's diet and see if the fluid clears up. I'm not sure why it happens, but I've heard of that working. Other than that, if you are sure that the hearing isn't affected nor the speech (and I think I'd have both of those tested from an ST and an ENT), then I wouldn't rush into tubes. But I also wouldn't take ANY chance that the hearing/speech are compromised.

 

Yeah... my understanding is speech delay is an indicator for tubes. He *sounds* normal to me. No funny pronunciations. Most all of his speaking his intelligible to others. If someone sounds normal, should you still get speech tested by a ST?

[Dmmetler]

You also might want to ask your doctor about trying Nasonex. DH has permanent tubes in his ears because, for some reason, when he got tubes as a child, his Eustachian tubes completely stopped functioning, and have never started up again. For this reason, when DD started having the pretty common infections as an infant, her pediatrician tried Nasonex before putting in tubes, because it's been shown to improve Eustachian tube functioning. She stayed on it until about age 4, then switched to an antihistamine during sinus congestion season to keep fluid down, and so far, it's worked well.

 

Be aware that Nasonex often isn't covered under insurance for this because it's an off-label use. We were able to get a discount and purchase directly from the company via a program our pediatrician's office could refer us for.

[rafiki]

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[Jann in TX]

I would trust an ENT over a Ped any day for ear issues... especially if the Ped wants to try a MONTH of anti-biotics! Crazy!! If an infection is present then there are topical drops that work so much faster with out going system wide for a whole month.

 

My DH had a tube put in a few years ago due to chronic infections.. it stayed in just over one year and he has been infection free since (having them in).

[Niffercoo]

Yeah... my understanding is speech delay is an indicator for tubes. He *sounds* normal to me. No funny pronunciations. Most all of his speaking his intelligible to others. If someone sounds normal, should you still get speech tested by a ST?

 

 

Because of the fluid issue, I sure would. I'd do the hearing test at an ENT's office, too. Not just the screening one at the ped's.

[littlebug42]

I would trust an ENT over a Ped any day for ear issues... especially if the Ped wants to try a MONTH of anti-biotics! Crazy!! If an infection is present then there are topical drops that work so much faster with out going system wide for a whole month.

 

My DH had a tube put in a few years ago due to chronic infections.. it stayed in just over one year and he has been infection free since (having them in).

 

I definitely think you need a referral to an ENT and I agree that you should have the hearing tested there. My dd8 had an ear infection 4 years ago and for about 6 months, we would go into the ped for rechecks and she kept saying their was fluid on the ear not resolving. We did go through several rounds of antibiotics as well. She referred us an an ENT for hearing test, which was fine, and when we saw ENT, he told us it was fine. No fluid.

[AnitaMcC]

I would go with the ENT recommendation and have tubes put in.

 

My youngest Ds failed his newborn hearing test in right ear due to fluid. At 4 weeks old he had a bad ear infection, and didn't show any signs after that of any new infections. But he continued to fail the hearing tests in right ear and at 6 months he had failed the hearing test in left ear (which he had originally passed in previous tests). At 10 months old he had tubes put in.

 

By the time he had surgery it was bad in both ears.... the ENT said if he had delayed the surgery till Ds was a year old (the earliest age for tubes this ENT normally went by) ...my son would have been deaf permanently. The fluid had crystallized and had to be scraped out. The ENT just said something in his instincts was saying... do the surgery now. And so he did. He said he hadn't seen it so bad in such a young child. Normally the severity Ds had was seen in children around age 5 or 6 who had chronic ear infections.

 

Ds didn't have any "symptoms" that stood out other than the failed newborn hearing test and the one infection. He was still too young to have flags raised about speech. He "seemed" to hear us and would pay attention to us when we talked to him. But he didn't crawl or stand or walk at all on his own. He was delayed in gross motor skills but again, at the time of surgery he was only 10 months old so still not that delayed. He was scooting around on his bottom and so it was thought that he just found a different way to get around and didn't want to crawl.

 

After the tubes were in it took Ds nearly 6 more months before he finally passed his hearing tests. Also, at 14 months he was still not crawling, standing, or walking. He didn't know how to balance. He had to go to physical therapy three times a week. In a few months he was running-LOL. At two years old he still wasn't talking more than 6 words and had to have speech therapy. By 3 he was speaking very well and was almost at age level.

[Mom0012]

I haven't read all the replies, but my daughter had terrible trouble with her ears from 6 months of age on. She always either had an infection going or she had fluid in her ears and she couldn't hear well. One summer, her eardrums ruptured 8 times. We did tubes 3 times and removed her adenoids when we put the 3rd set of tubes in. None of this ever helped her. Even after the tubes she would have puss draining out of her ears and be in terrible pain at night.

 

For my daughter, it turned out it was an intolerance to dairy. We removed it from her diet and two weeks later there was no more fluid and never has been. I removed dairy after reading a book called Healing Childhood Ear Infections. The doctor who wrote the book claimed 75% of his patients' ear problems resolved with the removal of dairy.

 

So, I know your situation is different from ours, but I would keep dairy in mind as the culprit. As I said, for us, we knew in two weeks that the diet change was worth it. Even though your child is not getting infections or having a speech delay, the fluid in the ears is likely affecting his hearing. My daughter is very bright and has no delays, but she went through many periods where I realized she could not hear much at all.

 

Lisa

 

Lisa

[MorganClassicalPrep]

A MONTH of antibiotics? Wow. I would never do that.

 

My experience with tubes comes from hearing loss/speech delay/serious painful ear infections!

 

I had tubes until I was 16. I had (and still have) hearing loss in both ears. When I don't have tubes I got constant ear infections. In fact, now that I have health insurance again I am going to ask for a referral to an ENT because I get painful ear infections 9-10 times a year. -sigh-

 

DD had tubes put in at 11 months. We started talking about putting them in at just 6 months old, but I wanted to hold out, because the younger you are when they go in, the more chance you'll need a second pair. By 11 months she had had double ear infections almost constantly, was delayed in her speech (not making many noises at all.) and was failing hearing tests. We put the tubes in and it was... well, a miracle! Like a light switch had flicked on.

 

I would go to an ENT over a ped for this. They have much more experience dealing with these types of issues!

[Spy Car]

We went through this. My son had insufficient drainage in one ear due to a relatively common issue with his Eustachian tubes that he would be expected to out-grow eventually.

 

This caused frequent ear-aches, and "humming" on his part. The Otolaryngologist recommended "tubes" (no surprise). Research on my part led to a great deal of conflicting information (no surprise).

 

We were told we risked hearing loss if the infections continued (as they almost certainly would) and that the procedure itself could cause a small amount of hearing loss, but it was better than the alternative.

 

We did it. The infections went away. There are no significant hearing issues, beyond a very (very) slight loss in some frequencies.

 

I'd do it again. But I still don't feel "fully informed."

 

Bill

[staceyobu]

I would trust an ENT over a Ped any day for ear issues... especially if the Ped wants to try a MONTH of anti-biotics! Crazy!! If an infection is present then there are topical drops that work so much faster with out going system wide for a whole month.

 

My DH had a tube put in a few years ago due to chronic infections.. it stayed in just over one year and he has been infection free since (having them in).

 

My understanding is that drops don't work for inner ear infections because they cannot penetrate the eardrum. Unless the eardrum has ruptured.

 

Okay, for all of you who say "SEE AN ENT"... in your experience does an ENT say much besides "lets put in a tube"??? I don't know of ANYONE that has seen an ENT for an ear issue and walked away without a tube (myself included!). I feel like seeing an ENT is surgery. Pretty much like if I went to a surgeon and said "I've got this pain in my knee". KWIM???

[Spy Car]

Okay, for all of you who say "SEE AN ENT"... in your experience does an ENT say much besides "lets put in a tube"??? I don't know of ANYONE that has seen an ENT for an ear issue and walked away without a tube (myself included!). I feel like seeing an ENT is surgery. Pretty much like if I went to a surgeon and said "I've got this pain in my knee". KWIM???

 

I suspect that you are correct. I felt it at the time we agreed to have a tube put in. My concern was on-going and persistent ear infections might lead to serious hearing loss. I'm still not sure what the consequences would have been had we not acted. Would it have been OK? Would there have been serious damage to my son's hearing? I simply don't know.

 

What I do know is the tubes cleared the infections, and my son's hearing is "normal". So knowing nothing more than I know today, I'd do it again. Do I know beyond certainly that it was the only (or best option)? I don't.

 

Bill

Edited June 18, 2010 by Spy Car

[staceyobu]

I suspect that you are correct. I felt it at the time we agreed to have a tube put in. My concern was on-going and persistent ear infections might lead to serious hearing loss. I'm still not sure what the consequences would have been had we not acted. Would it have been OK? Would their have been serious damage to my son's hearing? I simply don't know.

 

What I do know is the tubes cleared the infections, and my son's hearing is "normal". So knowing nothing more than I know today, I'd do it again. Do I know beyond certainly that it was the only (or best option)? I don't.

 

Bill

 

Yeah... you are pretty much summing up my thoughts. I've read a few studies that show children with tubes actually showed more hearing loss over the long term than children without. Although there were other factors that don't necessarily mean it was just because of the tubes.

 

I don't want my three year old to undergo unnecessary surgery. However, I try to imagine a conversation with the Ped and ENT.

 

The doctors: "Your son needs a tube or he will lose hearing in one ear."

Me: "No, I'm sorry. I don't believe that. I've been doing some reading on the interwebz."

 

I mean, what do I do but let him have the surgery, right? Hopefully it won't even come to that. Sigh.

[juelle]

Ds 14 has had fluid in his ears since at least the age of 2. His hearing was pretty bad when he was 3, and he had awful sleep apnea by age 4. It seems that all of this is due to allergies - environmental and probably lactose intolerance.

 

His tonsils and adenoids were so swollen that they were removed in an emergency surgery when he was 4 1/2. The ENT (whom we had met the day before - our family doc referred us immediately when we found ds blue in his bed because the apnea was so bad) put in tubes at the same time.

 

Ds's hearing improved and his ears drained some. His speech was always fine. Sometimes I wasn't sure if he just wasn't listening. :glare::glare: He akways seems to hear what he wants!

 

The tubes fell out over the years, and his hearing declined again. A CAT scan (which I probably wouldn't do if I had it all to do over) showed chronic infection deep in his sinuses, or so we were told. The ENT ran a course of strong, broad spectrum antibiotics for a month. No change. Another month. (What were we thinking!!!) Still nothing. So he did another surgery to put in new tubes. I think one tubes may still be in.

 

Ds fails the middle range of the hearing test at school every year. The school nurse bugs me about it every year. Every year I tell her the long, sad story I just told you. Reading it here, I can't believe he's been through all that. I very seldom medicate my children , and here this one kid had so much. As Bill said, I never felt well informed, though I did what research I could.

 

In my opinion, ds still doesn't drain through his Eustacian tubes and sinuses very well. He takes a homeopathic allergy remedy every day by his own choice, and it really helps him. Claritin is available to him, but he takes the Sabadil 99% of the time. I had him off dairy when he was younger, but he makes his own choices about that now - it's not an allergy/anaphylaxis issue, and he doesn't see a huge difference in how he feels.

 

I don't know if any of this helps. I guess my bottom line is: check for hearing loss and language development. Then, as you already know, be aware that the tubes may not be a perfect solution. Most kids do grow out of this because the Eustacian tubes develop and improve drainage on their own. But some don't. :001_smile:

[Spy Car]

 

The doctors: "Your son needs a tube or he will lose hearing in one ear."

Me: "No, I'm sorry. I don't believe that. I've been doing some reading on the interwebz."

 

I mean, what do I do but let him have the surgery, right? Hopefully it won't even come to that. Sigh.

 

I had this conversation. The Otolaryngologist had heard it all before, and he had very plausible counter-arguments for every study. And the "bottom line" from him was: Your son will most likely have serious hearing loss without this procedure, what do you want to do? :001_huh:

 

And at that point I made the only decision I could have lived with under the circumstances. And it went well.

 

Bill

[fhjmom]

Please see a pediatric ENT and audiologist. While a language delay may strongly indicate the possibility of hearing issues, the lack of language delay does not rule one out. Believe me, I know. I have two daughters (6 YO and 2 YO). Both have moderate-to-severe hearing loss. Both are well above age level in both receptive and expressive language skills. The 6 YO's loss was not diagnosed until she was 4 partly because no one would believe me when I said I thought she had a hearing loss because "she talked too good"; oh, and she faked her way through a screening at the pediatrician's office when she was 3 1/2.

 

I am not advocating for tubes. I honestly have no experience with them. But I do recommend that you find out how much he is (or isn't) hearing before you rule out the tubes.

[Ravin]

Our ped tried some meds to try and dry her out (not antibiotics) for a month before referring us to an ENT. DD was speech delayed and had EI speech therapy; she got ear tubes in and made some very rapid leaps such that she didn't qualify for preschool or speech therapy via the PS--i.e., within a month after the tubes were in, her speech was greatly improved.

 

Like your DS, she didn't get much in the way of infections (which I attribute to breastfeeding, because my DH and sisters all had horrible chronic ear problems with lots of infections), but unlike him she did have hearing impairment and some speech delay. I don't think I'd have gone for the surgery otherwise.

[texasmama]

My son had two sets of ear tubes. He has what appears to be permanent damage to his hearing due to the scarring from the tubes. If I had it to do over again, I wouldn't do it. If he had not had hearing damage due to scarring, I'm sure my opinion would be different. I made the best decision I could at the time...but I do regret it. I also agree with those who say that if you go to an ENT, tubes will be recommended. A month's worth of antibiotics sounds pretty mild compared to the risk of permanent hearing damage. No one can tell you which children will have hearing damage from the tubes...or from not using tubes. It is not an easy decision to make, and I don't envy you. I did want to add my experience.

[ClassicalTwins]

Yeah... my understanding is speech delay is an indicator for tubes. He *sounds* normal to me. No funny pronunciations. Most all of his speaking his intelligible to others. If someone sounds normal, should you still get speech tested by a ST?

 

 

Sounding "normal" to the parent or people he is around often isn't a good indicator that speech is OK. As parents we learn to understand them from babbling on....

 

As others have said have your child checked by a specialist and ENT and go from there. If we had had an ENT intervention we would have gotten tubes sooner and would not be dealing with speech issues at age 7, easier to correct speech problems earlier than later...

It is difficult to learn to read when you don't really "hear" the sounds properly, as explained by our ENT when there is fluid there for a long period of time, the child becomes used to it so it does not hurt, even if no fever it is not a good thing. Additionally, everyone around them sounds like they are in a fish tank when they speak so hearing phonics sounds is not learned, even though they can talk, reading is a whole new thing. We found our problem at 5.

[Joker]

I suggest an ENT as well. At least go for one visit and see what they say. When I was little I had many ear problems. My mom only took me to the ped. They rec. tubes - a few years later they rec. tubes again - and again. My mom finally took me to an ENT and was told I could barely breathe through my nose. It appears I was born that way and since it was all I knew it wasn't something I complained about or that anyone noticed. The ENT did surgery on my nose and I haven't had any problems since.

 

ETA: The ENT told us that only very few people should ever have tubes more than once. If it doesn't help then there is an underlying problem that needs to be addressed.

Edited June 18, 2010 by Horton

[Ellie]

You might consider eliminating all dairy products from your dc's diet. Diary is a mucus-causing food, and many children do have chronic ear infections and whatnot which cleared up when they no longer ate/drank dairy products.