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    Ear Tubes Not Always Needed

    Treating Buildup of Middle-Ear Fluid With Tubes May Not Improve Developmental Issues

    Watch-and-Wait Approach

    Earlier findings from the study were so convincing that they prompted a change in guidelines regarding the treatment of kids with persistent middle-ear fluid.

    Doctors are now urged to take a watch-and-wait approach to treatment, which includes frequent hearing assessments.

    If a hearing loss of 40 decibels or higher is documented or language delays are seen, tubes are recommended.

    Pediatric medicine expert Stephen Berman, MD, says the study by Paradise and colleagues should serve to reassure parents of children with persistent middle-ear fluid buildup.

    "Parents often want tubes because they are worried about developmental delays," he says.

    Berman, who is a pediatrician at Children's Hospital in Denver, tells WebMD that as many as 70% to 80% of children who get tubes in the U.S. have persistent fluid buildup without repeated infections.

    "About 400,000 tubes are put in a year [in the U.S.] at a cost of between $3,500 and $5,000 each," he says. "I would think that maybe half of these surgeries could be avoided. That money could be redirected to interventions that would actually impact child development."

    Such programs would include those designed to promote language and learning skills among low-income children, he says.

    "We know that poverty is independently associated with an increased risk for language and learning delays and these kinds of ear problems," he says. "The interpretation has been that the [ear problems] were causing the learning delays. But we now know that this is not true."

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