Waiting for Ear Tubes Won't Affect Child Development

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The new study involved 6,350 infants who were regularly evaluated for middle ear effusion during the first three years of life. During that time, 429 children were found to have persistent fluid in their ears -- meaning that the fluid was present for longer than 90 days.

The children were randomly assigned to promptly undergo ear tube surgery or to wait, sometimes for as long as nine months, before having the procedure done. The researchers periodically assessed the children until they were 9 to 11 years old, and at the end of the study had complete data from 391 youngsters -- 195 from the prompt-surgery group and 196 delayed-treatment group.

One hundred and eight children in the delayed group ended up never having the ear tube surgery.

All of the children underwent a battery of developmental assessments tests when they were 3, 4, 6 and between 9 and 11 years of age.

The result: No statistically significant differences were found between youngsters who quickly received ear tubes and those who were asked to wait.

"We found no differences in outcomes," said Paradise.

That doesn't mean that tubes should never be used, however. There are certain times when ear tubes are warranted, according to Paradise and Berman. Children who have frequent ear infections -- more than three episodes in six months or more than four episodes in a year, according to Berman -- may have fewer infections and suffer less pain if they get ear tubes.

Berman also said that if the pressure from the fluid is so high that it causes damage to the small bones of the ear, tubes are indicated. But, he said, that's a very rare problem. There are also conditions that put children at an increased risk of having developmental problems from persistent fluid, and those children should probably get tubes.

The bottom line, said Paradise, is that "if your child isn't otherwise ill, and there are no problems with frequent infections, they ought to have hearing tests every few months and be observed to see that nothing untoward is happening in the ear."

"It's fine to watch children and not have tubes put in," concurred Berman. "Your child should periodically see their pediatrician to make sure no developmental or language delays are occurring and that the hearing loss hasn't become severe."

More information

There's more on fluid in the ears at the American Academy of Pediatrics.