Early Ear Tubes Bring Lasting Hearing Benefit

Kids who receive ear tubes to treat ear infections have instant improvement in hearing. But what's the long-term outlook for these children?

Finnish researchers found that infants and young children who have ear tube surgery have hearing levels comparable to other children 14 years later. This is an important finding since even a slight hearing loss in childhood increases the likelihood of language and educational problems.

Ear infections are one of the most common diseases in early childhood. Children who live with smokers, attend day care, or use pacifiers may be at a higher risk of ear infections. Symptoms include pain, pulling or rubbing of the ears, high fever, vomiting, decreased appetite, and fussiness. Antibiotics are used to treat bacterial ear infections.

Recurrent ear infections, however, not only cause significant pain but can also lead to hearing loss or speech delay. Ear tube surgery for recurrent ear infections — called myringotomy — is the most common childhood surgery in the U.S.

Ear Tubes Instantly Improve Hearing

During this surgery a small opening is made in the eardrum. Plastic, hollow ear tubes are passed through the opening to help ventilate the area behind the ear drum and drain fluid that develops in the middle ear with recurrent ear infections.

Hearing almost instantly improves. But long-term effects on hearing and thus language development are less clear.

Hannu Valtonen, MD, PhD, and colleagues followed 237 children for 14 years after ear tube surgery. The children were between 5 and 16 months old at the time of surgery.

Most Kids Have Normal Hearing

Many children treated early in life with ear tubes require frequent checkups or continued treatment because of repeated ear infections. But at the end of the 14-year study 75 percent of the children's ears had completely healed. This was up from 66 percent when the researchers evaluated the children five years after ear tube placement.

Hearing in the kids with completely healed ears was the same as children with normal hearing.

Valtonen, who is at the Central Hospital of Central Finland in Jyvaskyla, published his study in the April issue of Archives of Otolaryngology.

Outlook Not as Good for Some

But the outlook wasn't quite so good for kids whose eardrums had not completely healed or who continued to have recurrent ear infections after ear tube surgery.

In those kids hearing loss was still evident, but it was generally mild. Some kids needed repeat ear tube surgery and they also tended to have some hearing loss.

The researchers say their results show that ear tube surgery early in life is safe and useful for preserving hearing as a child grows and develops.

By Michael W. Smith, MD, reviewed by Brunilda Nazario, MD

SOURCE: Valtonen, H. Archives of Otolaryngology, April 2005; pp 293-303.