Medical Health Encyclopedia

A 2004 study randomized 429 children younger than age 3 to receive either immediate or delayed myringotomy with tympanostomy tube insertion (M&T). The children were subsequently evaluated at age 5 for signs of tympanic membrane damage, and also had their hearing evaluated when they were 6 years old. Among the findings:

• There were no significant differences in hearing levels between the two groups, although the children’s hearing was slightly worse than children who did not have OME.
• However, 71% of the children who received immediate M&T had tympanic membrane abnormalities compared to 43% of the children whose M&T procedure was delayed.
• Based on these results, the researchers recommended watchful waiting for young children with uncomplicated middle ear effusion (MEE).
• The data also suggest that many children with persistent, early-life MEE may later have some ear damage regardless of whether they undergo the M&T procedure.

A 2005 study found similar results. The researchers also advised against prompt insertion of tympanostomy tubes in otherwise healthy children with MEE who are younger than age 3. The researchers recommended tubes for young children who have:

• Repeated occurrences of ear infection that are not controlled well by antibiotics or that keep recurring
• Middle-ear fluid and any degree of hearing loss
• Persistent middle-ear fluid accompanied by ear pain, ringing in the ear, or eardrum structural problems

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Earplugs as a Precaution. Many doctors feel that children should use earplugs when swimming while the tubes are in place in order to prevent infection. Others feel that as long as the child does not dive or swim underwater, earplugs may not be necessary. Parents should consult their own child's doctor on this subject. Cotton balls coated with petroleum jelly are effective alternatives to ear plugs. Children do not need to wear earplugs while showering.