Are Doctors Performing Ear Tube Surgery Too Often?

Every year, over 667,000 children, most of them whom are not even 5 years old, have ear tubes surgically inserted into their ears. Many parents are hesitant about this surgery because they don’t want to put their child under anesthesia. Ear tube surgeries are the most common type of surgeries using anesthesia, performed on children.

Currently, there are guidelines that were issued in 2014, but more guidelines are wanted. The American Academy of Otolaryngology-Head and Neck Surgery Foundation helped issue these guidelines in order to reduce the amount of unneeded surgeries. Richard Rosenfeld, chairman of otolaryngology at SUNY Downstate Medical Center in Brooklyn, N.Y. organized the group who put together the guidelines. They are already believed to have made a difference.

What are the new guidelines?

Currently, the new guidelines for ear tube insertion surgery state that they should only be inserted if the child has middle-ear fluid in at least one ear at the time of the examination. Children that have a regular fluid buildup in the middle ear of both ears for a minimum of three months, whether they have an ear infection or not, are also eligible for ear-tube surgery.

Before the new guidelines were introduced, numerous doctors recommended ear tubes in children who either experienced frequent ear infections, which were classified as 3 in 6 months or 4 in a year, that do not have fluid, or middle-ear effusion. Ear infections should be of concern because they have the ability to cause hearing loss that could result in developmental setbacks.

General anesthesia on children is also a large concern by doctors and parents. Anesthesia can be very dangerous and many parents do not want to expose their child to this type of procedure. Many doctors and researchers are currently trying out new devices that would enable ear tube surgery without using anesthesia. A device known as the Hummingbird, which was developed by Preceptis Medical, uses nitrous oxide as a sedative as opposed to general anesthesia. This would allow the ear-tube surgery to be performed in the doctor’s office as opposed to a hospital.

The procedure for inserting ear-tubes is the following; doctors cut a small hole inside the eardrum and place a small, cylindrical tube through it. The procedure takes less than ten minutes, so it is quite quick. After the tube is installed, it helps prevent the buildup of fluids in the back of the eardrum and it improves air flow. The ear tubes normally fall out within a year or two, which then causes the holes to close on their own. If the holes do not close on their own, doctors must surgically close them, but this is not too common. Even with ear tubes inserted, children can still get ear infections, but they are much less frequent.

In 2012, Tympanostomy Tubes Were One of the Five Topics That Were Discussed at the National Summit

They discussed the overuse of ear tubes in children but were not able to pin point the exact amount of overuse. Lawrence Kleinman, vice chair for research and education in the department of health evidence and policy at Mount Sinai School of medicine in New York came to conclusion that more than one in five of the surgeries that involve inserting ear tubes into the ears are not necessary. Doctors and researchers are working diligently in order to curb the amount of ear tube surgeries in children. Many parents cringe at the fact of letting their child be put under anesthesia for such a simple surgery. New technologies are continuing to be developed to give doctors more options to treat ear infections.

Don’t rush for Ear Tube Surgery

Though ear tube surgery is widely recommended by doctors and ENT specialists, it is not always the correct answer. In fact, there is no correct answer. Every child and every ear infection are different. Without diagnosing the child closely, to understand the source of recurrent ear infections, the right treatment cannot be given. Even if the doctor is sure that only Ear Tube Surgery will help, it is suggested to get a second opinion.

Ear infections in children are very common. Recurrent ear infections may jeopardize your child’s hearing, so it is important to have them diagnosed and treated. There is a variety of treatments, and before resorting to surgery, there are different approaches you may want to try.