Posts Tagged ‘ ear tubes ’

Efforts to Reduce Ear Tube Surgeries Slowly Having an Impact

Wednesday, June 18th, 2014

Last year, the American Academy of Otolaryngology—Head and Neck Surgery Foundation issued new guidelines that called for “watchful waiting” to take the place of rapid progress to ear tube surgery for kids who have frequent ear infections.  Now, a review of the procedure’s frequency across the U.S. shows that it is in fact reducing the number of ear tubes, which are surgically inserted while a child is under anesthesia, but perhaps not at the rate the foundation had hoped.  More from the Wall Street Journal:

While it’s too early to tell, “anecdotally it does seem to have made a difference,” said Richard Rosenfeld, chairman of otolaryngology at SUNY Downstate Medical Center in Brooklyn, N.Y. He chaired the task force that drew up the guidelines.

The guidelines state that for children with recurrent ear infections, ear tubes, or tympanostomy tubes, should be put in place only if middle-ear fluid is also present in at least one ear at the time of inspection. Children with persistent fluid buildup in the middle ear of both ears for at least three months, with or without an ear infection, are also candidates for ear-tube surgery.

Previously many doctors recommended ear tubes in children who either had recurrent ear infections—three in six months or four in a year—without fluid, or middle-ear effusion. Ear infections are concerning because of potential hearing loss that could cause developmental delays.

Contributing to a desire by doctors and parents to avoid surgery are concerns about the use of general anesthesia in young children. Researchers and doctors are exploring devices that would enable ear-tube procedures to be performed using alternatives. Preceptis Medical, a Plymouth, Minn., company, is testing a device, the Hummingbird, that uses nitrous oxide instead of general anesthesia in clinical trials at four sites, including the Mayo Clinic. Acclarent, a division of Johnson & Johnson, is working on using technologies that may allow for ear-tube procedures to be done in-office without general anesthesia, a spokeswoman said.

To insert tubes, doctors make a small cut in the eardrum and place the tiny, cylinder-like tube through it. It takes less than 10 minutes. The tube helps with air flow and prevents the buildup of fluids behind the eardrum. The tubes usually fall out within a year or two, and the holes close on their own, though sometimes a doctor must close them surgically. Children with tubes can still get ear infections, but doctors say they are generally less frequent, milder and can be treated with antibiotic drops.

Image: Ear exam, via Shutterstock

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First-Ever Guidelines About Ear Tubes in Kids

Tuesday, July 2nd, 2013

doctor looking in child's earThe first clinical guidelines ever created regarding the use of ear tubes—medically named tympanostomy tubes—were released yesterday by the American Academy of Otolargyngology-Head and Neck Surgery Foundation (AAO-HNSF).

These tiny tubes, about 1/20th of an inch, may be the best treatment for children suffering from ear aches, ear infections and middle ear fluid build-up. They work by allowing air to pass through the ear canal, which helps the fluid drain. The tubes are inserted into a child’s ear canal under light general anesthesia and will fall out naturally over time from wax and debris build-up in the ears.

According to Dr. Richard Rosenfeld, chairman of otolaryngology at SUNY Downstate Medical Center in Brooklyn, New York, the insertion of ear tubes is the number-one ambulatory surgery in children and the number-one reason they undergo anesthesia. However, until yesterday, “no national society has ever published evidence-based guidelines on the best way to do this,” he told CNN Health.

Written by a panel of pediatricians, ear, nose, and throat specialists, and an anesthesiologist, among others, these new guidelines address the implantation of ear tubes in children ages 6 months to 12 years. The guidelines suggest that children who have frequent ear infections that hold onto fluid (in other words, don’t clear up quickly) are good candidates for ear tubes. Children experiencing fluid build-up in both ears for 3-months or more may also need tubes since the clogged hearing affects their balance, motor skills, and quality of life in group settings—such as in the classroom or social situations. Additionally, children at risk for fluid build-up related delays, such as those with autism, Down syndrome, or other developmental delays, should also be given ear tubes according to the guidelines.

Interestingly, the guidelines dictate that tubes should not be given to those children with frequent ear infections that do not have fluid build-up, which is a deviation from standard medical practice. Ask your doctor if your child has fluid build-up in his or her ears. If your child does not, ear tubes should be avoided according to these guidelines.

Image: Doctor looking at child’s ear, via Shutterstock


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