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Don't Worry: Delaying Ear Tube Surgery Won't Harm Language Development

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Delaying Ear Tube Surgery Doesn't Harm Language Development continued...

This new study means that it is time to rethink current guidelines for tube surgery, says Stephen Berman, MD, president of the American Academy of Pediatrics. Berman, a professor of pediatrics at the University of Colorado Health Sciences Center in Denver, says that current guidelines suggest that tubes should be placed if fluid persists for at least three months. "But this new evidence suggests that it may be better to wait rather than perform an unnecessary procedure," he says.

Glenn Isaacson, MD, professor and chair of otolaryngology/head and neck surgery and chief of pediatric otolaryngology at Temple University School of Medicine in Philadelphia, says the study by the Pittsburgh researchers does call into question the three-month rationale but he says that "children who have tubes placed for persistent fluid represent only one segment of children in whom tubes are inserted."

Isaacson says that he is more likely to insert tubes to treat persistent, painful [ear] infections. And he says that he and other surgeons frequently observe "dramatic improvements in language after tubes are placed." But he says, "whether those dramatic changes will make a difference five years from now is unknown."

James M. Perrin, MD, associate professor of medicine at Harvard Medical School tells WebMD that although the findings from the Feldman study suggest that "[as of] age 3 it is probably better to wait rather than rush to insert tubes, the real question that remains is what the effect will be at ages 4, 5, and 6 [if surgery is delayed up to nine months]." Perrin wrote an editorial that accompanies the study by Feldman and a second study from Canadian researchers.

In the second study Peter C. Coyte, PhD, and fellow researchers from the University of Toronto studied hospital records from more than 37,000 children to determine if combining tube surgery with removal of adenoids, or tonsils and adenoids could improve outcome. Coyte tells WebMD that adding an adenoidectomy to the tube surgery reduced the need for repeat surgeries by 50% and when both adenoids and tonsils were removed the repeat procedures were cut by 60%.

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