Ear Tubes - Indications

Aside from circumcision, ear tube insertion is the most common surgical procedure in children in the United States. In most cases, ear tube insertion is performed on children between 6 months and 2 years of age.

Ear tube insertion may be recommended if your child has had fluid in the middle ear for more than 4 months along with hearing loss greater than 20 decibels (dB; unit used to measure the loudness of sound).

Some children may be too young for hearing loss to be quantified. In this case, the child's physician may recommend ear tubes if there is fluid in the middle ear lasting for more than 4 months and if the child shows clear signs of language delays.

Ear tubes may also be recommended for children who:

  • get recurrent ear infections that do not respond to antibiotics;
  • have special medical conditions, such as the following:
    • Cleft palate
    • Down syndrome
    • Immune system disorders
    • Injury from air pressure changes (called barotrauma)
    • Middle ear damage from ear infections

Some physicians caution that a significant number of ear tube surgeries may be unnecessary. This view is based on a large research study that looked at children who had persistent otitis media with effusion as toddlers. The study showed that when the children were later tested, there was no significant difference in language development between those children who had ear tube surgery and those children whose physicians adopted a "watch and wait" approach with no insertion of ear tubes.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 27 Aug 2008

Last Modified: 14 Sep 2015