Ear tube surgery not a long-term solution

Ear tube surgery can certainly improve hearing in the short term but may not help in long-term hearing, speech, language, or other functional outcomes in normally developing children.

In a key finding, researchers found that implanting tubes in the ears of children who have persistent or recurrent episodes of otitis media with effusion (OME) improves hearing over a short period but is less likely to improve long-term cognitive and functional development.

"We found that surgery can certainly help ease pain associated with ear pressure changes in the middle ear, and even improve hearing in the short term, but we found no evidence that surgical intervention improves longer-term development," said Michael Steiner, chief of general pediatrics and adolescent medicine at University of North Carolina School of Medicine.

OME is a collection of fluid in the middle ear without signs or symptoms of acute ear infection. The fluid decreases middle ear function, leading to hearing loss and occasional pain from the pressure changes, said the study published online in the journal Pediatrics.

The systematic review examined 41 studies and found that, compared with watchful waiting, implanting tubes decreased middle ear effusion and improved hearing up to nine months post surgery.

Limited evidence suggested that tube placement increased the rate of prolonged discharge from the ear or calcification of tissues in the ear compared with no ear surgery or just myringotomy - a surgical procedure of the eardrum or tympanic membrane.

Adenoidectomy also reduced time with ear infections and improved hearing up to two years compared with no treatment or as an adjunct to myringotomy; rarely, it increased the risk of postsurgical haemorrhage.

"With the large number of tube insertions done on children each year, more research needs to be done to assist clinicians and parents in understanding the level of improvement in quality of life and other patient-centered outcomes that these common procedures offer, especially for periods longer than 24 months," said Ina Wallace, senior research psychologist at RTI International and the study's lead author.