How many ear infections can you have before needing ear tubes? - Medical News Today

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People with recurring ear infections may need ear tubes, which are small tubes that allow air into the middle ear. Doctors may recommend tubes if a person has three infections requiring antibiotics within 6 months.

Additionally, doctors may recommend the tubes if an individual has ongoing ear infections with fluid buildup that each last at least 3 months. People may also need them if they have four infections requiring antibiotic treatment within 12 months.

Ear tube insertion is a minor procedure that is relatively common. In the United States, ear tube insertion is the most common outpatient surgery doctors perform on children.

Read more to learn about why and when a person needs ear tubes, the risks involved, and what to expect.

Ear tubes are small tubes made of metal, plastic, or other materials. An otolaryngologist — an ear, nose, and throat surgeon — inserts them through an eardrum. The tubes allow fluid to drain from the middle ear.

They are also called:

  • tympanostomy tubes
  • pressure equalization (PE) tubes
  • ventilation tubes
  • myringotomy tubes

Doctors recommend ear tubes to prevent recurring middle ear infections. Less commonly, they are used in people with a malformation or abnormal insertion of the eardrum or eustachian tube, which is the passageway between the throat and middle ear.

These may happen with:

  • Down syndrome
  • cleft palate
  • barotrauma, an injury to the middle ear stemming from a reduction in air pressure, which happens during altitude changes when flying

The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines recommend ear tubes for children with:

  • chronic infections with fluid buildup for 3 months or longer in both ears as well as documented hearing loss
  • chronic infection with fluid buildup for 3 months or longer in one or both ears as well as problems or symptoms due to the condition
  • at least three infections within 6 months or four infections within 12 months that involve treatment with antibiotics
  • children at risk for ear infections — such as those who have sensorineural hearing loss, speech delays, developmental disorders, and blindness — with fluid buildup in one or both ears which are unlikely to disappear within three months

Children are most likely to get ear tubes between the ages of 1 and 3. However, infants may get ear tubes as young as 6 months old.

The problems that necessitate ear tube insertion are more common in children. However, they may also occur in teenagers and adults.

If a person or their child needs ear tubes, they can expect the following:

Procedure

Ear tube insertion is an outpatient procedure, so an overnight hospital stay is typically not necessary.

First, a doctor administers anesthesia. In younger children, a doctor will use general anesthesia, a medication that puts them in an unconscious state. Some older children and adults can tolerate the procedure with local anesthesia, a medication that numbs the area.

A doctor will then make a small incision in the eardrum. They will remove fluid from behind the middle ear and place the tube.

The procedure itself takes just 5–15 minutes, and recovery is quick.

Recovery

Following the procedure, a healthcare professional will monitor the person in a recovery room. They can likely go home after 1–2 hours. However, they may be recovered enough after just 30 minutes.

After surgery, they may feel pain and grogginess. They can take eardrops to reduce discomfort and prevent clogging the tubes. A doctor should make an appointment for a follow-up visit.

The procedure is safe and very common. Complications are unlikely. However, they can occur.

Potential complications include the following:

  • Perforation: This is rare. However, it can happen when a tube falls out and the hole in the eardrum does not close. If this occurs, a surgical procedure can repair it.
  • Infections: These are usually infrequent and do not result in prolonged hearing loss.
  • Scarring: Repeated insertion of an ear tube may irritate the eardrum and cause scarring. Typically, this does not require treatment.
  • Ear tubes that stay in too long: Tubes that stay in too long may cause perforation and need to be removed.
  • Ear tubes that come out too early: If tubes fall out too early, the fluid buildup can return, so they will need to be re-inserted.

If a person has ear infections that last for a long time or constantly recur, it is a good idea to contact a doctor. They may recommend ear tubes.

Additionally, the Centers for Disease Control and Prevention (CDC) recommend contacting a doctor for children with ear infections if they:

  • have a fever of 102.2°F (39°C) or higher
  • have symptoms that worsen
  • have hearing loss
  • have fluid, pus, or discharge from the ear
  • have symptoms of an ear infection that last more than 2–3 days
  • have any other severe or concerning symptoms

The following are the answers to commonly asked questions.

How long do ear tubes stay in?

There are both short-term and long-term tubes. Short-term tubes usually stay in for 6–12 months before falling out. Long-term tubes stay in for 1 year or more.

How can I care for them?

Since ear tubes usually fall out on their own, they do not require care. However, if a tube remains in place for a long time, a doctor may choose to remove it surgically. Doctors usually check on people with ear tubes every 6 months until they have fallen out and the eardrums are healed.

People can keep their ears clean by wiping them gently with a damp cloth. They should not use cotton swabs or anything inserted into the ears.

How can I prevent future ear infections?

Follow the doctor's directions for using ear drops after the procedure. If infections recur, notify the doctor.

Additionally, the CDC offers the below tips for preventing ear infections:

  • get the flu and pneumonia vaccines
  • do not smoke and avoid exposure to second-hand smoke
  • gently dry ears after swimming
  • clean hands before touching the ears
  • avoid using pacifiers and bottles with kids

If a person has three infections within 6 months or four within 12 months, they may need ear tubes. However, doctors may recommend them for other reasons, too, such as chronic infections with fluid buildup for at least 3 months.

Ear tube insertions are very common and safe. However, complications are possible. The risks include perforations, infections, and scarring.

After the procedure, a person's hearing loss from fluid buildup may improve immediately. However, improvements in other problems, such as balance, may take weeks or months.

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