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Ear Tubes: Once Not Enough for Many Kids

One in Five Kids Require Repeat Procedures to Fight Ear Infections
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March 17, 2003 -- For the millions of young children who can't get relief from their persistent ear infections with antibiotics, insertion of ear tubes is often the only alternative. But a new study shows that about 20% of children who undergo the surgical procedure to get ear tubes will require additional surgery.

Ear infections are the most common cause of pediatrician visits among young children. Researchers say 9 out of 10 cases can effectively be managed with antibiotics, but drug treatment fails about in about 1 million children in the U.S. each year.

For these children, many doctors prescribe the insertion of tubes within the ear canal to allow better drainage and help reduce the risk of ear infections. The surgical procedure is so common among children that it is second only circumcision as the most common pediatric surgery. But until now, researchers say little was known about what affects the risk of children having to undergo additional procedures to have a second set of ear tubes inserted.

In the study, published in the March issue of the Archives of Otolaryngology-Head and Neck Surgery, researchers looked at 2,121 children who received the ear tubes over a five-year period. They found one in five of the children required a second set of tubes, and children who were 18 months old or younger at the time of their initial procedure were nearly twice as likely as other children have a repeat procedure.

Although younger age was associated with an increased risk for additional surgery, researchers say that age itself wasn't an independent risk factor for repeat procedures.

Researcher Mark Boston, MD, of Eastern Virginia Medical School, and colleagues found that children who also had a procedure known as an adenoidectomy to remove excess tissue from behind the nose at the time of their tube insertion procedure were much less likely to require a second set of ear tubes.

Other factors that increased the likelihood of needing additional ear tubes were having a facial abnormality, a family history of adenoidectomy or tonsillectomy with or without the insertion of tubes, and not having an adenoidectomy at the time of the initial ear tube placement.

Although an adenoidectomy lowered the risk of additional ear tubes for many children in the study, researchers say not all children who receive ear tubes for the first time require this procedure and more research is needed to determine who might benefit most from adenoidectomy at the time of initial tube placement.

SOURCE: Archives of Otolaryngology-Head and Neck Surgery, March 2003.

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