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Ear Tubes Not Worth the Risk or Cost

Sunday, 02 November 2008 12:02

Implanting ear tubes, an operation done on hundreds of thousands of toddlers each year, does not appear to improve their speech and learning development and may not be worth the risks and the cost, a study suggests.  Researchers in Pittsburgh looked at two groups of toddlers: those who got ear tubes after three months of fluid in their ears (the standard guideline) and those who waited up to nine months before tubes were inserted. The children were tested for speech, language, learning and behavior when they turned 3.  "The bottom line was there wasn't any difference in the developmental outcomes as best we could measure them at age 3," said Dr. Jack L. Paradise of Children's Hospital of Pittsburgh.


Paradise said there is a risk of complications from the anesthesia. Also, he said, the tubes sometimes leave perforations in the eardrums or scar them, or cause chronic drainage from the ear.  "If tubes were absolutely harmless and free, then I think you might say, 'Well, let's have the tubes to be sure,"' Paradisesaid. "But tubes themselves carry risk and, of course, there's cost  involved. So it becomes a matter of ... which set of risks would you rather take?  Paradisesaid he would hold off inserting tubes if the only concern was developmental problems from hearing loss.

Hoffman RA, Madell JR   Effect of early or delayed tympanostomy-tube insertion for persistent otitis media   N Engl J Med 2001 (Aug 9);   345 (6):   465;   author reply 465-6