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There is little advantage to surgeons inserting ear tubes to help prevent recurrent ear infections in children (1). Many young children suffer recurrent ear infections. The middle ear is an open space connected to the back of your throat by the Eustachian tube. Fluid produced in the middle ear flows down the Eustachian tube to be swallowed with saliva. Young children have narrow diameter Eustachian tubes that are easily blocked. Irritation or infection can swell the back of the throat and block the eustachian tube, causing fluid to collect in the middle ear so some children miss various sounds and are slow to develop hearing and speaking skills.

Surgeons make a hole in the tympanic membrane that separates the middle ear from the outside and place a tube in it so excess fluid can flow to the outside. 18 months after having ear tubes, children have no better verbal or social skills than children who were treated just with watchful waiting. It appears that too many children are having ear tubes to treat a condition that is usually self limiting. However, the concern that ear tubes would allow water to carry bacteria into the ear and cause serious infections is not supported. Children who have ear tubes are not more likely to get ear infections from putting their heads under water when they swim (2).

Most surgeons have stopped removing adenoids, the immune tissue located at the opening to the Eustachian tube. Adenoids of children who have had their adenoids removed to treat recurrent ear infections are not larger than those of other children (3). Some cases of fluid in the ears are caused by infection with mycoplasma which is killed only by erythromycin in children. The only other antibiotic that kills chlamydia is tetracycline which causes a child's teeth to turn brown, so it is not used (4). See report #7998.

Exciting new research shows that the buildup of fluid in the inner ear is probably caused by inactive cilia, the small hairs that line the eustachian tube and sweep fluid toward the mouth. Erythromycin antibiotics stimulate the cilia, remove fluid from the inner ear and help to relieve the discomfort (5,6). Xylitol chewing gum has also been shown to help clear fluid from the ear of children with recurrent ear infections. (7). Cortisone sprays can shrink the tissue lining the Eustachian tube, open it, let fluid pass to the mouth and cure some cases of chronic middle ear infections (8)

Checked 8/9/05

June 1st, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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