A child who has multiple ear infections that do not get better easily or who seems to have hearing loss or speech delay may be a candidate for ear tube surgery.

Published: March 23, 2017 | Updated: February 22, 2021

Your toddler is cranky and not her usual sweet self. She’s had her nap, so she can’t be tired. Suddenly she tugs at her ear and you think, “Oh, no, not another ear infection. Why is this happening again?”

Ear infections are caused by bacteria or viruses entering the middle ear through the eustachian tube. This can happen when a child has a cold or respiratory infection. When the middle ear becomes infected, it can fill with fluid. Pressure from the fluid buildup pushes on the eardrum and causes pain and sometimes a temporary decrease in hearing.

Some kids are more susceptible to ear infections than others. Antibiotics are often used to treat bacterial ear infections. But if an infection is caused by a virus, antibiotics won’t help: These infections have to get better on their own.

A child who has multiple ear infections that do not get better easily or who seems to have hearing loss or speech delay may be a candidate for ear tube surgery. With 2 million ear tubes placed in children in the U.S. each year, ear tube surgery is relatively common.

“More than 90 percent of children will have at least one ear infection,” said Jeffrey C. Nau, M.D., otolaryngologist. “When ear infections become a chronic problem and a child has fluid in the middle ear, hearing loss and balance issues can result. Referral to an otolaryngologist (ear, nose and throat specialist) will help determine if tubes can be beneficial.”

Getting ear tubes

Inserting ear tubes is a relatively simple surgery and the most common pediatric surgery performed with anesthesia. A child may receive a sedative at the hospital before being taken to the outpatient operating room. Once under general anesthesia, the otolaryngologist makes a small incision in the ear drum and inserts the tube, a small cylinder. The procedure takes about 15 minutes. Parents are often given a prescription for antibiotic ear drops.

“Tubes usually stay in for approximately one year,” Dr. Nau said. “By the time a child is 2 years old, the angle of the eustachian tube, which helps drain fluid from the ear, has changed. Many times replacement tubes are not needed. Children may have repeated ear infections and still not need tubes. It is important to talk to your pediatrician about the pros and cons of the procedure as it relates to your child.”