Medical questions & health advice by board certified doctors
"My 8 month old daughter has had 3 ear infections since she was 4 months, could she need tubes?"
My daughter got her first ear infection at four months, which turned into rsv, she was on a nebulizer and it went away, but the ear infection didn't, not for another 2 weeks of a different antibiotic. She has had two since then. And constant congestion.
First of all, I'm sorry to hear that your daughter has been dealing with so many ear infections. Otitis media (middle ear infection) is a relatively common problem in the pediatric population. In order to understand why someone would need tympanostomy tubes (ear tubes), you must first understand basic middle ear physiology. Normally sound waves enter the ear canal and traverse to the tympanic membrane (ear drum). The space medial to the tympanic membrane (TM) is the middle ear. There are three hearing bones I. The middle ear, and they attached in a chain to the TM. Thus when sound waves move the TM, they move these bones (malleus, incus, stapes). This mechanical signal is transmitted to the cochlea which is part of the inner ear, which converts the signal to an electrical impulse which is transmitted to your brain. In order for this process to work properly, the middle ear must be aerated (full of air). The air gets there through something called your eustacian tube, which goes from the back of the nose to the middle ear. This tube can be blocked for a multitude of reasons in children, which creates a vacuum in the middle ear and sucks fluid from the surrounding tissues causing a middle ear effusion. (This is a common theory of middle ear effusions). The fluid can then get infected resulting in recurrent infections. The tympanostomy tube therefore not only drains the fluid, but let's air in preventing formation of another vacuum. There is some debate amongst otolaryngologists (ENTs) about the absolute criteria for tubes. In general, most would agree that tubes should be placed if: There is a persistent effusion, it persists for more than 3 months of antibiotic therapy, 7 or more infections within 6-9 months, or a significant persistent conductive hearing loss. These criteria are by no means all inclusive, or exclusive for that matter. Every patient is different and as always I recommend making an appointment with your local ENT.