When does a child need ear tubes?

Ear tubes are one of the most common surgeries young children undergo. Around 500,000 children of all ages receive ear tubes every year to help fight ear infections as their ears grow and mature.

But just because ear tubes are common doesn't mean all children will need them. Learn more about ear tubes and find out if they are right for your child.

How do ear tubes work?

Ear tubes are small tubes that are inserted into a child's eardrum to equalize pressure across the eardrum and allow infection to escape from the middle ear space behind the eardrum. The middle ear is the area of the ear most likely to experience infections.

"Young children are at risk for ear infections because their eustachian tubes and immune systems are immature," explains Christopher Liu, M.D., Pediatric Otolaryngologist at Children's Health℠ and Assistant Professor at UT Southwestern. "Ear tubes allow for the treatment of ear infections with ear drops alone."

Ear tubes can also be used to help children who experience hearing loss due to fluid build-up, even if they don't experience ear infections.

Can you still get ear infections with tubes?

While ear tubes may reduce the number of ear infections, they don't stop infections completely. If your child does get an ear infection, there will be ear drainage and antibiotic ear drops can treat the infection. Ear drops are more effective and have fewer side effects than oral antibiotics. Children with ear tubes can use these drops, a major benefit of ear tube surgery.

How many ear infections before tubes are recommended?

While ear tubes are not medically necessary, they can help relieve the pain of middle ear infections and make those infections easier to manage.

Your child's doctor may recommend ear tubes if your child has:

• Hearing loss due to fluid build-up or
• More than 3 ear infections in 6 months or
• More than 4 ear infections in a year

Your child does not have to be a particular age for ear tubes. They may be infants or teens and still benefit from ear tubes.

But not all parents choose ear tubes for their children.

"It depends on the costs and benefits for each individual child," says Dr. Liu. "If parents don't like the idea of surgery and would rather wait for their child to grow out of ear infections, that is a reasonable approach as long as there are no other risk factors such as speech delay."

What is ear tube surgery like?

Surgery to place ear tubes (called a myringotomy) is a 5-10-minute outpatient surgery that is performed under general anesthesia. Most children are back to normal by evening and can go back to school or daycare the next day.

Parents can expect ear drainage for a week after surgery and will be given antibiotic ear drops to use for one week after surgery.

How long do tubes stay in ears?

Ear tubes typically stay in place for six months to a year before falling out on their own. Once ear tubes fall out, your child may need another set placed if they still experience frequent ear infections. However, they may also be fine without ear tubes.

If the ear tubes don't fall out, your doctor may let them stay in place for a few years before removing them.

How do I care for my child's ear tubes?

Ear tubes require little to no care at all. You need to attend follow up appointments with your child's ear, nose and throat specialist. You should also see the specialist if your child has lots of frequent ear drainage or if your child's pediatrician cannot see the tube in your child's ear.

Can kids with ear tubes go swimming?

A child with ear tubes does not need to wear earplugs routinely if he or she plans on going swimming. You may choose to use earplugs if your child is sensitive to water entering the ear or if your child is swimming in untreated water such as in a lake or a pond.

How can I reduce my child's risk for ear infections?

If you choose not to get ear tubes for your child, you may be able to reduce your child's risk for ear infections by performing good hand hygiene and eliminating secondhand cigarette smoke exposure. Your child might also be at a higher risk for ear infections if they attend daycare.

"Most children who need ear tubes are less than 3 years old," says Dr. Liu. "Fortunately, most children will outgrow this problem as their immune systems and ears mature. As a result, ear infections become less frequent as the child ages."

Learn more

Children's Health offers the largest group of ENT pediatric doctors in North Texas, which gives parents and patients access to expertise, support and services not available anywhere else. Learn more about Pediatric Ear, Nose and Throat program.

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