WHEN tubes and WHY tubes?

By: Brannon C. Perilloux, M.D.


When should a child get “tubes” and why should they?  This is a very frequent question amongst parents of children aged 9 months to 4 years old.  We as pediatricians here in Baton Rouge see many children daily, some with ear infections, and some ultimately go on to get “tubes” while the majority do not.  In most children watchful observation or antibiotics are very effective in treating ear infections. The Academy of ENT physicians has a set of recommendations regarding the decision of pediatricians to refer their patients to the ENT (ear, nose and throat specialists) for the insertion of tubes:


            (1) in children with single or double ear infections for 3 months or longer and symptoms that are likely caused by an ear infection including, but not limited to, balance problems, poor school performance, behavioral problems, ear discomfort, or reduced quality of life


            (2) in at-risk children with single or double ear infections  that are unlikely to resolve quickly as reflected by a flat tympanogram or persistence of fluid or infection for 3 months or longer.


(3) in children with 6-8 separately identifiable ear infections in a 12 month period of time


What are the benefits of ear tubes?

Ear tubes, or myringotomy tubes, are placed in a child’s ear by an ENT doctor during a brief outpatient surgery called tympanostomy. These small tubes are most often placed because of persistent fluid in the middle ear, recurrent ear infections or ear infections that persist despite antibiotic treatment. Potential benefits of ear tubes includes improved hearing, reduced fluid in the middle ear and and reduced incidence of ear infections.


What are some of the negatives of having ear tubes? 

Surgery, no matter how quick and easy, always has risks with anesthesia.  While most children do fine, there can be post-op complications.  Some kids will have some restrictions in activities like swimming under water in a pool.  Some will occasionally have a slight drainage out of the ear.


Who decides?

The decision to place tubes in a child’s ear is not something to take lightly and many details factor into the decision.

Our four pediatricians, Rodger Elofson, MD; Dana Fakouri, MD; Brannon Perilloux, MD; and Lori Cook, MD; all take into account the recommendations listed above, the patient’s actual situation and input from the parents before making a decision to refer a child to the ENT for “tubes.”


The decision to place tubes in a child’s ear is something we take seriously.  If you are worried about your child’s ear infections, please discuss them with your pediatrician.